Article type
Year
Abstract
Background:
There is an increased interest in Public Private Partnerships (PPPs) for improving maternal and newborn health (MNH) in low- and middle-income countries (LMICs). However, there is a lack of collated evidence on PPP performance and relative effectiveness of the various competing PPP models.
Objectives:
Systematically, we aim to review evidence on effectiveness of PPPs on MNH and comparative edge of different PPP models.
Methods:
Systematically, we reviewed evidence from LMICs on the effectiveness of PPPs for MNH and the comparative edge of different PPP models.
Results:
Evidence from 27 studies suggested an overall increase in the utilization of maternal health services including improved antenatal care (ANC), caesareans (C-sections) and institutional delivery with limited data on postnatal care (PNC) and maternal mortality. Voucher schemes improved both ANC and PNC utilization as well as access to institutional deliveries with little impact on emergency care. Evidence from maternal conditional cash transfers indicated increase in institutional deliveries and reduced maternal mortality while contracting out of services had a positive impact on delivery and ANC. There is little evidence of increased access to emergency and PNC with contracting out and contradictory results on immunization. National and community-based health insurance resulted in significant improvement in facility-based births and C-sections, but with little evidence of translation into promotive pregnancy care. User fee exemption initiatives have conclusively resulted in increasing institutional deliveries.
Conclusions:
Existing evidence suggests the potential benefits of PPPs, however future PPPs should be better designed with standardized evaluations for a range of MNH services. Programs should also focus on the contextual factors for future sustainability and program replication.
There is an increased interest in Public Private Partnerships (PPPs) for improving maternal and newborn health (MNH) in low- and middle-income countries (LMICs). However, there is a lack of collated evidence on PPP performance and relative effectiveness of the various competing PPP models.
Objectives:
Systematically, we aim to review evidence on effectiveness of PPPs on MNH and comparative edge of different PPP models.
Methods:
Systematically, we reviewed evidence from LMICs on the effectiveness of PPPs for MNH and the comparative edge of different PPP models.
Results:
Evidence from 27 studies suggested an overall increase in the utilization of maternal health services including improved antenatal care (ANC), caesareans (C-sections) and institutional delivery with limited data on postnatal care (PNC) and maternal mortality. Voucher schemes improved both ANC and PNC utilization as well as access to institutional deliveries with little impact on emergency care. Evidence from maternal conditional cash transfers indicated increase in institutional deliveries and reduced maternal mortality while contracting out of services had a positive impact on delivery and ANC. There is little evidence of increased access to emergency and PNC with contracting out and contradictory results on immunization. National and community-based health insurance resulted in significant improvement in facility-based births and C-sections, but with little evidence of translation into promotive pregnancy care. User fee exemption initiatives have conclusively resulted in increasing institutional deliveries.
Conclusions:
Existing evidence suggests the potential benefits of PPPs, however future PPPs should be better designed with standardized evaluations for a range of MNH services. Programs should also focus on the contextual factors for future sustainability and program replication.