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Demand-side Financing and Promotion of Maternal Health
What has India Learnt?
Use of demand-side financing has become increasingly common in maternal healthcare and India has been a leading example with large-scale programmes such as the Janani Suraksha Yojana and Indira Gandhi Matritva Sahyog Yojana. This paper undertakes a systematic review of the evidence to consider how demand-side financing has been used and whether there has been any impact on maternal health service utilisation, maternal health, or other outcomes. The findings suggest that a relatively narrow focus on achieving targets has often overburdened health facilities, while inadequate referral systems and unethical practices present overwhelming barriers for women with obstetric complications. The limited evidence available also suggests that little has been done to challenge the low status of poor women at home and in the health system.
This article was written with support from a King’s Partnership Grant, King’s College, London. The evidence used was collected during a systematic review by Murray et al (2012), which was funded by the Australian Agency for International Development (AusAID Agreement Number 59613) as part of the 2010 Australian Development Research Awards. We would like to acknowledge our colleagues Debra Bick and Tim Ensor for their role in the design and conduct of that broader review, and the many people who provided assistance in identifying studies for inclusion in it (see Murray et al for a list of names and organisations).
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