Abstract

Background: Providing equal opportunities for the newborn to survive requires a comprehensive approach. One of the approaches to provide equal opportunities for the new born is by promoting birth at the institutions. Nepal faces its unique challenges for meeting the public health goals. While some of the most common barriers toward safe delivery are related to access, cultural practices, lack of healthcare human resource, and inadequate healthcare financing. The government of Nepal in 2005 has initiated an incentive scheme, for the women to deliver at the health facility and to the provider for each delivery attended.

Objective: To assess the perspectives of the beneficiaries of Safe Delivery Incentive Program on the domains of benefits, difficulties, use of the cash incentive, and any recommended changes in the program.

Materials and Methods: This study utilizes a qualitative methodology by the use of in-depth interviews to learn about the perception of women about the scheme. Thirty in-depth interviews were conducted with the beneficiaries in randomly selected three wards in Khandbari Municipality. Manual qualitative data analysis was carried out using open coding and axial coding techniques according to Grounded Theory approach to derive a conceptual framework eliciting the perceptions.

Result: Beneficiaries in this study perceive this program as beneficial but not adequate to address the economic burden of childbirth to poor families and to those who are living in the distant health facilities. They find difficulty in availing the scheme in terms of delay in getting money and lack of proper information about the program. Decision-making was mainly by husband and pattern of utilization hugely deviated from the intended purpose (i.e., transportation). They also suggest providing the incentive beforehand and relaxing the clause of ANC as a part of the incentive. Empowerment, both financial and awareness based, emerged as a dominant theme that the women perceived as a benefit of the program.

Conclusion: The findings of the study mention cash transfer mechanism in the program has significantly empowered women. This model for women’s empowerment in developing countries should be explored in greater depth.

Key words: Cash incentive, institutional delivery, Safe Delivery Incentive Program, women’s empowerment