Systematic Reviews of Mechanisms for Financing Family Planning: Findings, Implications, and Future Agenda.

The article describes an international collaboration that systematically reviewed the evidence on financing mechanisms for family planning/contraception, assessed the strength of and summarized the evidence, identified research gaps, and proposed a new research agenda to address the gaps. The review found that the evidence base is weak owing to the paucity of studies, diversity in findings, and variations in intervention, study design, and outcome measures. Of more than 17,000 papers reviewed only 38 met the eligibility criteria. A number of general recommendations on the directions and areas of future research can be drawn. There is a strong need for more robust study designs on the effectiveness of financial incentives in family planning.

Community-Based Financing of Family Planning in Developing Countries: A Systematic Review.

In this systematic review, we gather evidence on community financing schemes and insurance programs for family planning in developing countries, and we assess the impact of these programs on primary outcomes related to contraceptive use. To identify and evaluate the research findings, we adopt a four-stage review process that employs a weight-of-evidence and risk-of-bias analytic approach. Out of 19,138 references that were identified, only four studies were included in our final analysis, and only one study was determined to be of high quality. In the four studies, the evidence on the impact of community-based financing on family planning and fertility outcomes is inconclusive. These limited and mixed findings suggest that either: 1) more high-quality evidence on community-based financing for family planning is needed before any conclusions can be made; or 2) community-based financing for family planning may, in fact, have little or no effect on family planning outcomes.

Family Planning Vouchers in Low and Middle Income Countries: A Systematic Review.

Family planning (FP) vouchers have targeted subsidies to disadvantaged populations for quality reproductive health services since the 1960s. To summarize the effect of FP voucher programs in low- and middle-income countries, a systematic review was conducted, screening studies from 33 databases through three phases: keyword search, title and abstract review, and full text review. Sixteen articles were selected including randomized control trials, controlled before-and-after, interrupted time series analyses, cohort, and before-and-after studies. Twenty-three study outcomes were clustered around contraceptive uptake, with study outcomes including fertility in the early studies and equity and discontinuation in more recent publications. Research gaps include measures of FP quality, unintended outcomes, clients' qualitative experiences, FP voucher integration with health systems, and issues related to scale-up of the voucher approach.

Mobilising financial resources for maternal health.

Coverage of cost-effective maternal health services remains poor due to insufficient supply and inadequate demand for these services among the poorest groups. Households pay too great a share of the costs of maternal health services, or do not seek care because they cannot afford the costs. Available evidence creates a strong case for removal of user fees and provision of universal coverage for pregnant women, particularly for delivery care. To be successful, governments must also replenish the income lost through the abolition of user fees. Where insurance schemes exist, maternal health care needs to be included in the benefits package, and careful design is needed to ensure uptake by the poorest people. Voucher schemes should be tested in low-income settings, and their costs and relative cost-effectiveness assessed. Further research is needed on methods to target financial assistance for transport and time costs. Current investment in maternal health is insufficient to meet the fifth Millennium Development Goal (MDG), and much greater resources are needed to scale up coverage of maternal health services and create demand. Existing global estimates are too crude to be of use for domestic planning, since resource requirements will vary; budgets need first to be developed at country-level. Donors need to increase financial contributions for maternal health in low-income countries to help fill the resource gap. Resource tracking at country and donor levels will help hold countries and donors to account for their commitments to achieving the maternal health MDG.

Estudio de costos del paquete materno-neonatal / Study of expenses of mother newborn package

El objetivo de este documento es detectar los principales obstáculos en la asignación de los recursos destinados al sector de la salud, para que estos puedan ser eliminados y para que los servicios logren cubrir una cantidad cada vez mayor de pacientes de un modo más eficiente, disminuyendo la mortalidad materna e infantil y mejorando el nivel de vida de nuestro país