|[Cashlinkedto|pecificserviceuse|||
|---|---|---|---|
|<br>1)JSY, India|<br>In-facility births have increased atthe national level. Slight<br>increase in ante-natal care and shiftfrom home based<br>attended delivery<br>to in-facility delivery. Of the LOlow in-<br>facility birth states, same had low uptake such as Bihar<br>(15%) and UttarPradesh (7%), while others suchas Orissa<br>and Madhya Pradesh had high uptake (42% and 44%).<br>District level variations are significant:from under5% in<br>141 districts to more than or equal to 30% in 128 districts.||Receipt offinancial assistancefrom JSYwas generally<br>higher inthe middle bands ofwealth in highfocus (lowin<br>|facility birth) states and inthosewith middle levels of<br>education -the poorestand least educated did not<br>|necessarily benefitthe most as perprogram objectives. The<br>highest rates ofJSY paymentswere towomen living in rural<br>areas, but close to a health facility. Except inthe northeast<br>|states,womenfrom the socially disadvantaged casteswere<br>significantlymore likely thanwerethe other groups to<br>receive JSY payments|Hot assessed, howeverthere is evidence that<br>[not all eligiblewomen received payments.<br>An assessment of<sup>five high-focus states in</sup><br>India indicated that 7-33% ofwomenwho<br>|delivered in facilities reported not receiving<br> |anymoney after delivery|
|2/SDIP, Nepal<br>|Women in the treatedgroup were 4.3 percentage points<br>(26 percent) more likelyto deliver in a publichealth<br>facility,4.2 percentage points (17percent) more likelyto — <br>deliver with a skilled birth attendantand 1.2percentage<br>points (36 percent) more likelytohave a caesarean section.<br>The impact varies dependingonthe size ofthe financial<br>package relative tothe cost of care and the quality of care<br>provided in hospitals and primary health care centres.<br>|The richer households benefited more as had higher<br>utilisation rates. Poorer women<br>also less likelytobe<br> |informed. However, interms ofincreased likelihood of<br>having a supervised delivery, the main impact was onthe<br> |middle quintile (66% more likely ifexposedtotheSDIP)<br>andthe lower two quintiles (64% more likely ifexposed to<br>|the SDIP)<br>|20% offacility costs covered on average, so<br>households are noteffectivelyprotected.<br>Out-of-pocketpayments for institutional<br>|delivery care disrupt living standards and<br>force some households into poverty. 12.8<br>|percentofhouseholds incurred expenditures<br>for delivery care that exceeded 10percent of<br>total consumption (the standard threshold<br>for catastrophicexpenditure). Out-of-pocket<br>payments also pushed an additional 1.9<br>percent ofhouseholds into extreme poverty,<br>equivalent<br>to a 25 percentincrease in<br>poverty.<br>|
|vouchers||||
|<br>3|Chiranjeevi<br>Yojana,<br>Gujurat, India,<br>2005 onwards|<br>In firstyear, institutional deliveries inthe five districts<br>increasedfram 38per cent to59 percent.4.7% of<br>|deliveries in thegroupwere caesareans. A later report<br>=<br>|statesthatpublic sectorinsitutional deliveries have been<br>= <br>declining|<br>A household-level survey of beneficiaries (n=262) and non- <br>users (n=394) indicated that the scheme iswell-targeted to<br>the poor (only 6% of beneficiaries were non-poor) but<br> |manypoorpeople do not use the services.|<br> |The beneficiaries saved more than Rs 3,000<br>|(USS$75) in delivery-related expenses and<br>were generally satisfied with the scheme,<br>although5% reported notreceiving transport<br>funds and4% reported being askedfor<br>moneyby staff.An average of Rs 654was<br>spend per person on additional medicines.|
|4/OBA, Kenya|Significant increase in uptake of safe motherhood services; <br>limited increase in the uptake ofFP services (possibly<br>driven by socio-cultural/other<br>factors)||Where abilityto pay is low, Marie Stopes pays forthe<br>vouchers. In rural areas,95% ofvouchers purchased by MSK<br>(the service provider)|Households benefitfrom high subsidies (e.g.<br>|200 KES for delivery package, compared to<br>600-1,500KES fordelivery in public sector<br>(plusadditionalcostsfordrugs,ANC,PNC)|