Publication: Demand-side Financing for Sexual and Reproductive Health Services in Low and Middle-Income Countries : A Review of the Evidence
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Date
2012-10
ISSN
Published
2012-10
Author(s)
Witter, Sophie
Abstract
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.
Link to Data Set
Citation
“Witter, Sophie; Somanathan, Aparnaa. 2012. Demand-side Financing for Sexual and Reproductive Health Services in Low and Middle-Income Countries : A Review of the Evidence. Policy Research Working Paper; No. 6213. © World Bank, Washington, DC. http://hdl.handle.net/10986/12036 License: CC BY 3.0 IGO.”
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