Why Poor Women Don’t Deliver at Health Facilities in Developing Countries? A Comparison of Economic and Cultural Barriers

Mona Sharan, World Bank Group
Qingfeng Li, Johns Hopkins University

Among all health indicators, the largest inequality pervasively persists in maternal health care utilization. Recently, Results-Based Financing has emerged as an innovative mechanism to increase demand. An increasing number of countries are providing cash incentives to women to seek antenatal care and deliver in health facilities. All these economic incentive based programs are based on the assumption that the huge inequality in maternal health care utilization is primarily due to economic barriers to accessing care. The current fad of donors supporting incentive based financing has been recently questioned. A key question remains: Is economic barriers the main reason for poor women not seeking delivery care skilled birth attendants or at health facilities? Using Demographic and Health Survey (DHS) data from 24 developing countries, we examine the reasons for women not delivering at health facilities. We show that the economic reason is not the main barrier for women not delivering at health facilities.