Based on experience of implementing the Maternity Incentives Scheme across the country, and the recommendations of an independent evaluation carried out by the Institute of Child Health in London, the Nepal Government has approved a revised set of implementation guidelines (23rd November 2007). Three key points are highlighted.
1. The parity condition, which previously only allowed women to receive incentives for up to two children, has been removed. Any mother delivering in a health facility, regardless of the number of children, is eligible.
2. Medical colleges and community hospitals (missionary and NGO run hospitals) can now also join the scheme and provide incentives to women who deliver at the facility, although health workers in these facilities are not eligible to receive incentives.
3. Priority for allocation of funds, reflecting government priority for encouraging women to deliver at a health facility and supporting the poorest districts is:
a. Provide incentive to the mother first
b. After providing incentives to mothers, government heath institutions in the 25 low HDI districts can claim the institutional subsidy
c. Third priority is incentives for health workers providing institutional delivery services
d. Fourth priority is incentives for health workers providing home delivery services.
The Maternity Incentives Scheme provides a lump sum payment to women who deliver their babies in a health facility, to help them meet their travel costs. An incentive is also paid to trained health workers for every birth they assist, whether at home or in a facility, and there is provision for an institutional subsidy for every facility delivery in 25 selected low HDI districts. The main aim of this initiative, which was launched nationwide in 2005, is to encourage the use of skilled attendance at every birth and thus save maternal and newborn lives. These revised guidelines will enhance the effectiveness of the scheme.