Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis
Financial incentives for health providers and households are increasingly used to improve reproductive, maternal, and child health service coverage in low- and middle-income countries. This study provides a quantitative synthesis of their effective...
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World Bank, Washington, DC
2021
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| Online Access: | http://documents.worldbank.org/curated/undefined/426541633376367601/Financial-Incentives-to-Increase-Utilization-of-Reproductive-Maternal-and-Child-Health-Services-in-Low-and-Middle-Income-Countries-A-Systematic-Review-and-Meta-Analysis http://hdl.handle.net/10986/36344 |
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okr-10986-363442021-10-13T05:10:43Z Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis Neelsen, Sven de Walque, Damien Friedman, Jed Wagstaff, Adam FINANCIAL INCENTIVE PERFORMANCE-BASED FINANCING CONDITIONAL CASH TRANSFERS VOUCHERS REPRODUCTIVE HEALTH MATERNAL HEALTH CHILD HEALTH META-ANALYSIS Financial incentives for health providers and households are increasingly used to improve reproductive, maternal, and child health service coverage in low- and middle-income countries. This study provides a quantitative synthesis of their effectiveness. A systematic review was conducted of the effects of performance-based financing, voucher, and conditional cash transfer programs on six reproductive, maternal, and child health service indicators, with eligible evidence coming from randomized controlled trials and studies using double-difference, instrumental variables, and regression discontinuity designs. Four literature searches were conducted between September 2016 and March 2021 using seven academic databases, Google Scholar, development agency and think tank websites, and previous systematic reviews. Random effects meta-analysis was used to obtain mean effect sizes. From 58 eligible references 212 impact estimates were extracted, which were synthesized into 130 program-specific effect sizes. Financial incentives increase coverage of all considered reproductive, maternal, and child health indicators, but mean effects sizes are of modest magnitude. Effect size heterogeneity is typically low to moderate, and there is no indication that study bias risk, baseline indicator levels, or a combination of provider- and household-level incentives impact effect sizes. There is, however, weak evidence that mean effect sizes are somewhat smaller for performance-based financing than for voucher and conditional cash transfer programs, and that the increase in income, rather than the incentive itself, drives coverage improvements. Financial incentives improve reproductive, maternal, and child health service coverage. If future research confirms the preliminary finding that performance-based financing has smaller effects, voucher and conditional cash transfer programs are the preferred policy option among incentive interventions to achieve higher reproductive, maternal, and child health service coverage. The relative effectiveness and efficiency of incentives compared with unconditional increases of provider and household incomes, however, need to be studied further. 2021-10-12T17:29:38Z 2021-10-12T17:29:38Z 2021-10 Working Paper http://documents.worldbank.org/curated/undefined/426541633376367601/Financial-Incentives-to-Increase-Utilization-of-Reproductive-Maternal-and-Child-Health-Services-in-Low-and-Middle-Income-Countries-A-Systematic-Review-and-Meta-Analysis http://hdl.handle.net/10986/36344 English Policy Research Working Paper;No. 9793 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English |
| topic |
FINANCIAL INCENTIVE PERFORMANCE-BASED FINANCING CONDITIONAL CASH TRANSFERS VOUCHERS REPRODUCTIVE HEALTH MATERNAL HEALTH CHILD HEALTH META-ANALYSIS |
| spellingShingle |
FINANCIAL INCENTIVE PERFORMANCE-BASED FINANCING CONDITIONAL CASH TRANSFERS VOUCHERS REPRODUCTIVE HEALTH MATERNAL HEALTH CHILD HEALTH META-ANALYSIS Neelsen, Sven de Walque, Damien Friedman, Jed Wagstaff, Adam Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis |
| relation |
Policy Research Working Paper;No. 9793 |
| description |
Financial incentives for health
providers and households are increasingly used to improve
reproductive, maternal, and child health service coverage in
low- and middle-income countries. This study provides a
quantitative synthesis of their effectiveness. A systematic
review was conducted of the effects of performance-based
financing, voucher, and conditional cash transfer programs
on six reproductive, maternal, and child health service
indicators, with eligible evidence coming from randomized
controlled trials and studies using double-difference,
instrumental variables, and regression discontinuity
designs. Four literature searches were conducted between
September 2016 and March 2021 using seven academic
databases, Google Scholar, development agency and think tank
websites, and previous systematic reviews. Random effects
meta-analysis was used to obtain mean effect sizes. From 58
eligible references 212 impact estimates were extracted,
which were synthesized into 130 program-specific effect
sizes. Financial incentives increase coverage of all
considered reproductive, maternal, and child health
indicators, but mean effects sizes are of modest magnitude.
Effect size heterogeneity is typically low to moderate, and
there is no indication that study bias risk, baseline
indicator levels, or a combination of provider- and
household-level incentives impact effect sizes. There is,
however, weak evidence that mean effect sizes are somewhat
smaller for performance-based financing than for voucher and
conditional cash transfer programs, and that the increase in
income, rather than the incentive itself, drives coverage
improvements. Financial incentives improve reproductive,
maternal, and child health service coverage. If future
research confirms the preliminary finding that
performance-based financing has smaller effects, voucher and
conditional cash transfer programs are the preferred policy
option among incentive interventions to achieve higher
reproductive, maternal, and child health service coverage.
The relative effectiveness and efficiency of incentives
compared with unconditional increases of provider and
household incomes, however, need to be studied further. |
| format |
Working Paper |
| author |
Neelsen, Sven de Walque, Damien Friedman, Jed Wagstaff, Adam |
| author_facet |
Neelsen, Sven de Walque, Damien Friedman, Jed Wagstaff, Adam |
| author_sort |
Neelsen, Sven |
| title |
Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis |
| title_short |
Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis |
| title_full |
Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis |
| title_fullStr |
Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis |
| title_full_unstemmed |
Financial Incentives to Increase Utilization of Reproductive, Maternal, and Child Health Services in Low- and Middle-Income Countries : A Systematic Review and Meta-Analysis |
| title_sort |
financial incentives to increase utilization of reproductive, maternal, and child health services in low- and middle-income countries : a systematic review and meta-analysis |
| publisher |
World Bank, Washington, DC |
| publishDate |
2021 |
| url |
http://documents.worldbank.org/curated/undefined/426541633376367601/Financial-Incentives-to-Increase-Utilization-of-Reproductive-Maternal-and-Child-Health-Services-in-Low-and-Middle-Income-Countries-A-Systematic-Review-and-Meta-Analysis http://hdl.handle.net/10986/36344 |
| _version_ |
1764485114265337856 |