Transfers are generally sized to close the gap between average consumption in the bottom quintile of the income distribution and the extreme poverty line. Payments are usually provided to women, and compliance with conditions is verified by the programme. These programmes have two main objectives: first, to provide a safety net to smooth the consumption of the extremely poor (alleviating short-term poverty) and, second, to increase the human capital investment of poor households (alleviating long-term poverty). CCT is a component of social programmes that condition regular cash payments to poor households on the use of certain health services and school attendance. The reasons behind the limited use of maternal health services by the poor are myriad and occur on both demand (households, women) and supply (provider) sides but a key demand-side obstacle relates to financial barriers ( 6).Ĭonditional cash transfer (CCT) is a type of demand-side programme that has been used in overcoming financial barriers to healthcare. Further, skilled birth attendance and the use of antenatal care are most inequitably distributed in 12 key maternal, newborn and child health interventions studied in low- and middle-income countries (LMICs), with poorer women facing higher barriers to access ( 4). Family planning needs are met for only about 50% of women ( 4), and total fertility rate (TFR) is still very high in low-income countries ( 5). Annually, about 60 million women give birth outside of health facilities, mainly at home and 52 million without a skilled birth attendant ( 3). Most of these deaths occur in the intrapartum and immediate postpartum period largely from preventable causes ( 1, 2). Given the slow decline in maternal and newborn mortality since 1990, the achievement of Millennium Development Goal 4 and 5-reducing infant mortality rate by two-thirds and maternal mortality rate by three-quarters from 1990 to 2015–is unlikely. We recommend more rigorous impact evaluations that document impact pathways and take factors, such as cost-effectiveness, into account. Given these positive effects, we make the case for further investment in CCT programmes for maternal and newborn health, noting gaps in knowledge and providing recommendations for better design and evaluation of such programmes. The programmes have not had a significant impact on fertility while the impact on maternal and newborn mortality has not been well-documented thus far. The CCT programmes have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers and reduced the incidence of low birthweight. We carried out a systematic review of studies on CCT that report maternal and newborn health outcomes, including studies from 8 countries. Conditional cash transfer (CCT) programmes have been shown to increase health service utilization among the poorest but little is written on the effects of such programmes on maternal and newborn health. Further, skilled birth attendance and the use of antenatal care are most inequitably distributed in maternal and newborn health interventions in low- and middle-income countries. According to UNICEF, 60 million women give birth outside of health facilities, and family planning needs are satisfied for only 50%. However, the slow decline in maternal and newborn mortality jeopardizes achievements of the targets of MDGs. Maternal and newborn health (MNH) is a high priority for global health and is included among the Millennium Development Goals (MDGs).
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