ArticleHealth policy and planning2024
Closing the gap? Results-based financing and socio-economic-related inequalities in maternal health outcomes in Zimbabwe.
Article in Health policy and planning, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Urban-Rural Disparities in Non-Adherence to Iron Supplementation Among Pregnant Women Aged 15 to 49 in Sub-Saharan Africa.International journal of environmental research and public health · 2025Article
- Assessing the joint effects of education, economic status, empowerment, and employment (4Es) disparities on the co-coverage of maternal, newborn and child health care services in sub-Saharan Africa: an application of the intersectionality approach.Journal of global health · 2025Article
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Abstract
The results-based financing (RBF) programme, first implemented in Zimbabwe in 2011 and gradually expanded to other districts, aimed to address disparities in maternal health outcomes by improving the utilization of health services. This study leverages the staggered rollout of the programme as a quasi-experimental design to assess its impact on asset wealth-related inequalities in selected maternal health outcomes. The objective is to determine whether RBF can effectively reduce these disparities and promote equitable healthcare access. We employ an extended two-way fixed effects (ETWFE) model to exploit temporal variation in RBF implementation as well as individual-level variation in birth timing for identification. Utilizing pooled cross-sectional and nationally representative data from the Zimbabwe demographic and health surveys collected between 1999 and 2015, our analysis reveals significant reductions in relative and absolute maternal health inequalities, especially in the frequency and timing of prenatal care, delivery by caesarean section and family planning. Specifically, the RBF programme is associated with reductions in disparities for completing at least four or more prenatal care visits (-0.026, P < 0.01), first-trimester prenatal care (-0.033, P < 0.01), delivery by caesarean section (-0.028, P < 0.005) and family planning (-0.033, P < 0.005). Additionally, the programme is associated with improved prenatal care quality, as evidenced by progress on the prenatal care quality index (-0.040, P < 0.01). These effects are more pronounced among lower socio-economic groups in RBF districts, highlighting RBF's potential to promote equitable healthcare access. Our findings advocate for targeted policy interventions prioritizing expanding access to critical maternal health services in underserved areas and incorporating equity-focused measures within RBF frameworks to ensure inclusive and effective healthcare delivery in Zimbabwe and other low-income countries.
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