Rethinking cash transfers to promote maternal health: good practice from developing countries

Working and discussion papers
November 2011
Nicola Jones, Fiona Samuels, Laura Gisby and Elizabeth Presler-Marshall

Quality maternal health care is a fundamental right for all women. Its links to child survival and development, to health care strengthening and environmental sustainability make it imperative for broader development goals, including the achievement of the Millennium Development Goals (MDGs).

This Background Note reviews the evidence on conditional cash transfers (CCTs) to promote safe motherhood – a concept that spans not only care during pregnancy and childbirth, but access to family planning and equitable health services – comparing them to other approaches to maternal health programming in developing countries.

Depending on the context, CCTs may offer a value-added approach to meeting safe motherhood (SM) needs. While evaluative data are slim, there is evidence that CCTs can and do have significant impacts on SM goals and on broader human development goals.

The ‘basket’ of CCT services reflects the inter-relatedness of today’s needs and those of tomorrow. CCTs typically offer nutritional support, antenatal care and access to skilled delivery, all of them critical to infant and maternal health, and invest more broadly in the development of household human capital through access to, and supply of, improved education and health services.

This review of evidence suggests a number of practice and policy implications:

  • Programmes should be contextualised
  • Appropriate infrastructure – including personnel –processes and systems are critical
  • Adequate funding is critical
  • The nature of funding matters
  • Targeting is crucial
  • Conditionalities, if included, need to be tailored to context
  • Complementary programmes are important, especially those linked to behaviour change (e.g. social marketing and women’s groups
  • Government ownership and political commitment are critical, and
  • Monitoring, evaluation and learning are integral to progress.