Skip to main content

Table 3 Variations in implementation

From: The experiences of districts in implementing a national incentive programme to promote safe delivery in Nepal

Policy Practice
1. Conditional cash transfer to women
Women who deliver in a public health facility –
hospital, primary health centre or health post –
are entitled to a cash payment if they have no more
than two living children or an obstetric complication.
The cash is given at the time of discharge.
If referred, the woman is to receive the
cash from the referring institution.
▪ Cash given to women delivering at home
▪ Cash given to women delivering in sub-health posts
▪ Cash given to all women, and not limited to those with no more than two living children or an obstetric complication
▪ Reduced amount of cash given to women, because the health institution did not have sufficient funds
and equally divided the money among the eligible women
▪ Cash amount deducted from the patient's bill in the absence of any cash to hand over to the woman
▪ Cash given on a first come first served basis or selectively due to insufficient funds
▪ Cash not given at time of discharge but at a later time
▪ Cash given to the relatives of women on proof of identity
▪ Cash given to women with abortion complications (not in the policy)
▪ Cash given to women by the referral hospital, rather than the referring institution
▪ No cash given
2. Health provider incentive
Government health professionals –
medical doctor, nurse, midwife,
health assistant, auxiliary health worker
and maternal and child health worker
– are entitled to an incentive for every
delivery they attend either at home
or at a government health facility
▪ Incentive to health workers given only for attendance at those deliveries in which the woman
has no more than two living children or an obstetric complication
▪ Incentive divided up among all staff involved in delivery care
▪ Incentive given to a single health professional involved in the delivery
▪ A share of the incentive taken by non health professionals – eg. the accountant
▪ Incentive given to health professionals for attending institutional deliveries only, not home deliveries
▪ Incentive claimed by health professionals for attending deliveries in private clinics
▪ No incentive given to health professionals
3. Free delivery care to women
Women eligible for the cash incentive
and resident in a low human development district
are also entitled to free delivery care.
The health institution is reimbursed 1,000 NRS
for each case of free delivery care given
▪ Free delivery provided to all women, and not limited to
those with no more than two living children or an obstetric complication
▪ Health institution not reimbursed for the free delivery