Demand-side Financing for Sexual and Reproductive Health Services in Low and Middle-Income Countries : A Review of the Evidence

Demand-side financing approaches have been introduced in a number of low and middle-income countries, with a particular emphasis on sexual and reproductive health. This paper aims to bring together the global evidence on demand-side financing mecha...

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Bibliographic Details
Main Authors:	Witter, Sophie, Somanathan, Aparnaa
Format:	Policy Research Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ACCESS TO EDUCATION ACCESS TO SERVICES ADOLESCENT ADOLESCENT HEALTH ADOLESCENTS ADULT HEALTH ALLOCATIVE EFFICIENCY ANTENATAL CARE BEHAVIOR CHANGE BEHAVIOUR CHANGE BIRTH ATTENDANTS BIRTH SPACING BIRTH WEIGHTS CAESAREAN SECTION CAESAREAN SECTIONS CAPITATION CARE FOR ADOLESCENTS CHILD HEALTH CHILD HEALTH CARE CHILDBIRTH CIRCUMCISION CLINICS COMMUNITY HEALTH CONDOMS CONTRACEPTIVE USE COST EFFECTIVENESS COUNSELING CULTURAL BARRIERS DEATHS DELIVERY CARE DESCRIPTION DEVELOPING COUNTRIES DEVELOPMENT POLICY DISTRICTS DOCTORS DRUGS EDUCATED WOMEN EMERGENCY OBSTETRIC CARE EMPOWERING WOMEN EQUITABLE ACCESS EXCESS FERTILITY EXTERNALITIES FAMILIES FAMILY PLANNING FEE FOR SERVICE FEMALE FEMALE ADOLESCENTS FINANCIAL MANAGEMENT FIRST AID GENDER GIRLS GLOBAL DEVELOPMENT GONORRHEA GOOD GOVERNANCE HEALTH CARE HEALTH CARE COSTS HEALTH CARE SERVICES HEALTH COSTS HEALTH FACILITIES HEALTH FACILITY HEALTH FINANCING HEALTH INSTITUTIONS HEALTH INSURANCE HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH POLICY HEALTH PROMOTION HEALTH RISKS HEALTH SECTOR HEALTH SEEKING HEALTH SEEKING BEHAVIOUR HEALTH SERVICES HEALTH SYSTEMS HEALTH WORKERS HIGH-RISK HOME DELIVERIES HOSPITAL HOUSEHOLDS HOUSING HUMAN DEVELOPMENT HYGIENE IMMUNIZATION IMMUNIZATIONS IMPACT EVALUATIONS IMPROVEMENTS IN QUALITY OF CARE INCENTIVE SCHEMES INCOME INFECTION PREVENTION INFORMATION SYSTEMS INSTITUTIONAL CAPACITY INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE INTERNATIONAL POLICY INTERVENTION JA LEVEL OF DEVELOPMENT LIVE BIRTHS LOW-INCOME COUNTRIES MALE CIRCUMCISION MATERNAL HEALTH MATERNAL HEALTH CARE MATERNAL HEALTH SERVICES MATERNAL MORTALITY MEDICAL FACILITY MIDWIFE MILLENNIUM DEVELOPMENT GOALS MINISTRY OF HEALTH MODERN CONTRACEPTION MODERN CONTRACEPTIVES MORTALITY MOTHER NATIONAL HEALTH NATIONAL HEALTH SYSTEM NATIONAL POLICIES NEONATAL CARE NEWBORN NUMBER OF BIRTHS NUTRIENT SUPPLEMENTATION NUTRITION NUTRITIONAL STATUS OBSTETRIC CARE OBSTETRIC COMPLICATIONS PATIENT PATIENTS PERINATAL DEATHS PHARMACIES PILOT PROJECTS POLICY DISCUSSIONS POLICY FORMULATION POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLITICAL LEADERSHIP POLITICAL SUPPORT POOR FAMILIES POPULATION ACTIVITIES POSTNATAL CARE PREGNANCIES PREGNANCY PREGNANCY CARE PREGNANT WOMAN PREGNANT WOMEN PREVENTIVE HEALTH PREVENTIVE HEALTH CARE PREVENTIVE STRATEGIES PRIMARY HEALTH CARE PRIMARY SCHOOLS PRIVATE PROVIDERS PROCESS EVALUATION PROGRESS PROVIDER INCENTIVES PROVIDER PAYMENT PUBLIC HEALTH PUBLIC POLICY PUBLIC SERVICES QUALITY ASSURANCE QUALITY CARE QUALITY OF CARE QUALITY OF SERVICES RADIO REPRODUCTIVE HEALTH REPRODUCTIVE HEALTH CARE REPRODUCTIVE HEALTH INTERVENTIONS REPRODUCTIVE HEALTH SERVICES REPRODUCTIVE SERVICES RESEARCH METHODS RISK GROUPS RURAL AREAS SAFE DELIVERY SAFE MOTHERHOOD SANITATION SEX SEX WORKERS SEXUAL BEHAVIOR SEXUAL HEALTH SEXUALLY TRANSMITTED INFECTIONS SKILLED ATTENDANT SKILLED BIRTH ATTENDANCE SKILLED BIRTH ATTENDANTS SOCIAL MARKETING SOCIAL PROTECTION MECHANISMS SPILLOVER STERILIZATION STIS SURGERY SYPHILIS TOLERANCE TRANSPORTATION TREATMENT SERVICES UNFPA UNWANTED BIRTHS URBAN AREAS URBAN SLUMS USER FEES VIOLENCE VOUCHER SCHEME VOUCHER SCHEMES YOUNG CHILD
Online Access:	http://documents.worldbank.org/curated/en/2012/10/16788706/demand-side-financing-sexual-reproductive-health-services-low-middle-income-countries-review-evidence http://hdl.handle.net/10986/12036

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Summary:	Demand-side financing approaches have been introduced in a number of low and middle-income countries, with a particular emphasis on sexual and reproductive health. This paper aims to bring together the global evidence on demand-side financing mechanisms, their impact on the delivery of sexual and reproductive health services, and the conditions under which they have been effective. The paper begins with a discussion of modalities for demand-side financing. It then examines 13 existing schemes, including cash incentives, vouchers, and longer term social protection policies. Based on the available literature, it collates evidence of their impact on utilization of services, access for the poor, financial protection, quality of care, and health outcomes. Evidence on costs and cost-effectiveness are examined, along with analysis of funding and sustainability of policies. Finally, the paper discusses the preconditions for effectiveness of demand-side financing schemes and the strengths and weaknesses of different approaches. It also highlights the extent to which results for sexual and reproductive health services are likely to be generalizable to other types of health care. It is clear that some of these policies can produce impressive results, if the preconditions for effectiveness outlined are met. However, relatively few demand-side financing schemes have benefited from robust evaluation. Investigation of the impact on financial protection, equity, and health outcomes has been limited. Most importantly, cost effectiveness and the relative cost effectiveness of demand-side financing in relation to other strategies for achieving similar goals have not been assessed.

Demand-side Financing for Sexual and Reproductive Health Services in Low and Middle-Income Countries : A Review of the Evidence

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