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Information communication technologies can serve as a crucial missing link toward tacking wicked problems of social welfare policy implementation through collaborative governance. Using a mixed methods approach, a pre- and postanalyses were used to investigate whether and how cell phones can increase awareness of pregnant women about different cash and service benefits of maternal health benefit policies of 82 pregnant women in a remote tribal community in Melghat forest of Maharashtra, India. Pregnant women received customized prerecorded bilingual audio calls on their mobile phones about maternal health benefit policies. The author then traced whether those audio messages increased the claiming of policy benefits and public engagement. The key contribution of this research is that contrary to the optimism about digital governance, findings suggest that cell phones are not a “silver bullet” for increasing receipt of maternal health benefits. This book chapter concludes with the prescription that the impact of mobile phones and other information technologies will be marginal as long as there are administrative deficiencies in policy implementation and a misalignment in state and federal policy designs.

This chapter discusses various aspects of family planning initiatives on a global scale, with a specific focus on their influence in Asian contexts, including Bangladesh. This chapter examines the diverse range of family planning programs and policies implemented worldwide, in Asia and Bangladesh considering cultural factors that significantly shape family planning decisions. By highlighting the unique approaches and challenges faced in different regions, it provides valuable insights into the evolving landscape of family planning efforts and their impact on population dynamics.

Objective – The first wave of experiences of exemptions policies suggested that poverty-based exemptions, using individual targeting, were not effective, for practical and political economic reasons. In response, many countries have changed their approach in recent years – while maintaining user fees as a necessary source of revenue for facilities, they have been switching to categorical targeting, offering exemptions based on high-priority services or population groups. This chapter aims to examine the impact and conditions for effectiveness of this recent health finance modality.

Methodology/approach – The chapter is based on a literature review and on data from two complex evaluations of national fee exemption policies for delivery care in West Africa (Ghana and Senegal). A conceptual framework for analysing the impact of exemption policies is developed and used. Although the analysis focuses on exemption for deliveries, the framework and findings are likely to be generalisable to other service- or population-based exemptions.

Findings – The chapter presents background information on the nature of delivery exemptions, the drivers for their use, their scale and common modalities in low-income countries. It then looks at evidence of their impact, on utilisation, quality of care and equity and investigates their cost-effectiveness. The final section presents lessons on implementation and implications for policy-makers, including the acceptability and sustainability of exemptions and how they compare to other possible mechanisms.

Implications for policy – The chapter concludes that funded service- or group-based exemptions offer a simple, potentially effective route to mitigating inequity and inefficiency in the health systems of low-income countries. However, there are a number of key constraints. One is the fungibility of resources at health facility level. The second is the difficulty of sustaining a separate funding stream over the medium to long term. The third is the arbitrary basis for selecting high-priority services for exemption. The chapter therefore concludes that this financing mode is unstable and is likely to be transitional.

This chapter provides a comprehensive examination of the diverse strategies employed in various Asian regions to address family planning. Beginning with an in-depth analysis of family planning programs in South Asia, this chapter offers a comparative overview that highlights the unique characteristics and outcomes within this dynamic context. Furthermore, this chapter employs case studies to explore the multifaceted influences of religious beliefs, legal frameworks, and sociocultural factors on family planning practices. By delving into these complexities, it offers a nuanced understanding of the challenges and successes in different Asian regions. This comparative exploration equips policymakers and practitioners with valuable insights to inform more effective and culturally sensitive family planning initiatives.

It is estimated that approximately 3,000 women develop obstetric fistula, leading to unhealthy pregnancy, early and prolonged labor, and in some cases stillbirth in Tanzania every year. Fistula often compounds the vulnerability of the women who are victims of a poor health facility, early marriage, and other gender gaps.

In this chapter, the author explores the extra-medical causes of fistula in remote locations (Pwani Region) of Tanzania from a practitioner’s perspective. The author considers the stories of four women who experienced fistula. The author interviewed the women over a period of five years between 2013 and 2018. Using narrative analysis, the author examined the interviews.

The narrative analysis indicates that fistula is a product of a gender biased social system that favors men, ultimately limits women’s freedom, stifling their development. Importantly, the main value of this analysis is to promote awareness that aside from medical treatment, social interventions are required to reconstruct the social belief system and eliminate the stigma associated with obstetric fistula. A list of social interventions that proactively manage the incidence of fistula and help integrate affected women back into the society sustainably is recommended.

Considering the recent trends of the increasing globalization of the market economy and the diffusion of democracy, the modern world needs to pay closer attention to pro-women and pro-girls policies if gender discrimination is to be challenged. Such policies could mark an era of building greater gender equality across the world by strengthening domains of women’s well-being that have been shown to decline in the initial years of the democratization and globalization of countries.

Women, who have more complex societal roles than men and whose employment is more tenuous, are more vulnerable to the rapid restructuring in macro-political and economic systems and bear more of the costs of systemic changes. My world-scale analyses show that women and men benefit unequally from the growth of democracy and the global economy – men’s well-being improves with the growth of democracy and globalization but women’s well-being declines. According to my follow-up studies, the decline lasts for over a decade (2014). These findings suggest that prior results of research proposing that democracy and the global economy improve people’s well-being are most likely biased when gender and the level of development in countries are not accounted for. To protect women and girls and to avoid gender discrimination, globalizing and democratizing countries should prioritize gender mainstreaming in their policies.

Migrant women face unique difficulties, such as labour discrimination, limited sexual and reproductive health (SRH) services, obstacles to family reunification, gender-based violence (GBV) and human trafficking. ¹ The European Commission's labour integration approach currently fails to account for these difficulties. Civil society organisations (CSOs) and non-governmental organisations (NGOs) attempt to fill these gaps but lack capacity and funding. The European Commission's current approach does not respect human dignity and impedes the migrant community's integration and inclusion. This chapter discusses sexual assault and gender-based violence, which may be disturbing to some readers.

This issue is relevant and important because migrant women comprise a large portion of the migrant population ² and are a vital part of the migrant community. The methodology used in this chapter is a human security framework with a people-centred approach to policy that empowers those impacted by it. Research for this chapter was conducted using news articles, academic articles, UN reports and publications. Based on this, the European Commission must take a holistic and binding approach that protects the rights and dignity of migrant women.

There are multiple approaches that the European Commission can take to incorporate human dignity into its policies towards women and migration, such as applying international conventions and implementing policies that account for migrant women. All approaches must be realistic and required of all member states.

Women’s empowerment is a multidimensional concept that encompasses different aspects such as access to education, freedom to make vital decisions, labor market access, wages, and political participation, among others. In this research, the authors construct a multidimensional index of women’s empowerment that takes into account individual resources and achievements and analyze its evolution across countries using data from the United Nations Development Programme and the United Nations for 17 gender indicators across 96 countries over the period 1995–2015. By means of exploratory and confirmatory factor analysis, the authors identify three dimensions of women’s empowerment: reproductive health, economic participation, and basic education. In addition, the authors use cluster techniques to classify countries into four groups with similar behavior patterns in the different domains of women’s empowerment: a group of countries with high levels in the domains of reproductive health and basic education but with low levels in economic participation; a group of countries with high levels in the domains of reproductive health and economic participation that should pay attention to education; a group of countries with medium levels across the three dimensions of women’s empowerment, especially in reproductive health and economic participation; and a group of countries with low levels in all the dimensions of women’s empowerment, especially in reproductive health and basic education. The comparison of these different patterns serves to highlight the aspects in which improvements have been made or, on the contrary, to highlight the obstacles that are hindering the improvement of gender equality. Finally, the results suggest that advancements in women’s empowerment improve the countries’ level of development.

The first section of this volume is concerned with the changing context for health financing in developing and transitional countries. Two chapters address contemporary issues. The first, by Cristina Gutiérrez-Delgado and Veronica Guajardo-Barrón, describes the challenges created by the “double burden” of disease in low- and middle-income countries created by the coexistence of the persistent burden of communicable disease with emerging problems of chronic and non-communicable illness. Drawing on the Mexican experience of expanding needs for anti-retroviral therapy, renal replacement therapy, and screening and prevention of cervical cancers, they present new evidence about the burden placed by these conditions on public health budgets. They also show the potential value of adopting a risk factor approach to economic evaluation of chronic disease management, presenting estimates of the financial burden imposed by four diseases strongly associated with overweight and obesity. They conclude that strengthened stewardship functions, including generating data about disease burdens and expenditure, and greater use of explicit priority setting processes, are needed to help resolve the tensions between equity and efficiency.