Financial incentives are increasingly being advocated as an effective means to change health-related behaviours and improve health outcomes. There is, however, little evidence on whether financial incentives work in low-income countries, particularly when implemented at scale. This paper explores the impact of a national programme in Nepal – the Safe Delivery Incentive Programme (SDIP) – that provides cash incentives to women conditional on them giving birth in a government health facility. Using propensity score matching methods, we find that the programme had a positive, albeit modest, effect on the utilisation of maternity services. Women who had heard of the SDIP prior to childbirth were 4.2 percentage points (17 percent) more likely to deliver with a skilled birth attendant. The treatment effect is positively associated with the size of the financial package offered by the programme and the quality of care provided in hospitals and primary health care centres. We argue that these results are not driven by omitted variable bias.
Hanson, K.; Powell-Jackson, T. Financial Incentives for Maternal Health: Impact Evaluation of a National Programme in Nepal. Social Science Research Network, Rochester, New York, USA (2010) 28 pp.