title: The promise of Mama Kits: Perceptions of in-kind goods as incentives for facility deliveries in Uganda.
abstract: There is growing interest in the use of incentives to increase the utilisation of maternal health services globally, including the use of in-kind goods. As part of the Saving Mothers, Giving Life (SMGL) programme, pregnant women in three districts in Uganda were incentivised to deliver in a facility by the promise of 'Mama Kits' - clean delivery kits augmented with goods for newborns. We collected and analysed qualitative data from 18 focus groups (130 women) who had a recent home (N = 9) or facility delivery (N = 9 groups) to understand their overall perceptions of the SMGL programme, and, in particular, the Mama Kit. There was a high level of awareness of Mama Kits among women who delivered in a health facility and a moderate awareness among women who delivered at home. When available, kits positively affected women's perceptions of facility delivery because they associated availability of kits with affordability of care. When not available, women's perceptions of their actual or expected delivery experience were negatively affected. When well implemented, in-kind goods can be important complements in broader efforts to incentivise facility delivery. Inconsistent implementation and an underestimation of their influence on care-seeking can undermine efforts to reduce maternal mortality and morbidity.
authors.affiliation: a Department of Epidemiology , Columbia University , New York City , NY , USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Austin-Evelyn
authors.affiliation: a Department of Epidemiology , Columbia University , New York City , NY , USA.|b USAID Maternal and Child Survival Program (MCSP)/ICF International , Washington , DC , USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Sacks
authors.affiliation: c School of Public Health , Makerere University , Kampala , Uganda.
authors.forename: Lynn
authors.initials: L
authors.lastname: Atuyambe
authors.affiliation: a Department of Epidemiology , Columbia University , New York City , NY , USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Greeson
authors.affiliation: d Department of Global Health and Population , Harvard T.H. Chan School of Public Health , Boston , MA , USA.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Kruk
authors.affiliation: e Wagner School of Public Service , New York University , New York City , NY , USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Grépin
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D017144:Focus Groups; D037921:Gift Giving; D006801:Humans; D007231:Infant, Newborn; D000068097:Maternal Health; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D009042:Motivation; D010465:Perception; D011247:Pregnancy; D036301:Qualitative Research; D014454:Uganda; D055815:Young Adult
keywords: Mama kits; Uganda; facility delivery; in-kind goods; maternal health; perceptions