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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.

Bottom of the Pyramid (BOP); social innovation and business modeling.

Undergraduate and graduate level management/business school students. It can be taught in marketing management and entrepreneurship/innovation courses.

LifeSpring Hospitals Pvt. Ltd is an expanding chain of hospitals that provide high quality health care to lower-income women and children across Andhra Pradesh. It is a 50-50 equity partnership between Hindustan Latex Ltd and the Acumen Fund. LifeSpring has demonstrated exceptional management principles, some of them being the most innovative and attractive ones. The entire focus of LifeSpring is on one particular niche: maternal care. Some argue about its strategy of not adopting diversification, but LifeSpring has proved its point by actually turning out to be a profitable business. The strategy of focusing on one niche has led to reduction in cost in terms of specialized doctors and the range of equipment needed to serve. Adding to the strategic strength of LifeSpring, its operations (management) is perfectly aligned with the organization's vision and quality is achieved via highly standardized procedures for maternal care service.

This case will cover two important aspects of BOP and social innovation. MBA students will investigate an innovative business model and apply their analytical skills to analyse the sustainability of the model.

Teaching notes and exercise for class-based discussion.

In 2016, the World Health Organization (WHO) revised upwards the recommended contacts for antenatal care (ANC) by expectant mothers with a health provider from a minimum of four to eight over the pregnancy period. Although Ghana is yet to adopt the new recommendation, some women choose to adhere to the new protocol because of its enormous health benefits to the expecting mother and the unborn child. As part of ANC, family planning services are also provided to ensure child spacing and birth control. To reduce health costs, government introduced the free maternal health policy, Community-based Health Planning Services, Livelihood Empowerment Against Poverty and established the Northern Development Authority to increase access to healthcare and also create wealth. Given these interventions, the study hypothesizes that household wealth would not have a significant influence on antenatal visits and modern contraceptive use. Therefore, this paper aims to examine whether household wealth would play any significant role on the new minimum contacts proxied by antenatal visits and also on the use of modern contraceptives as a family planning counselling tool during ANC visits. The study further examines a possible heterogeneity effect of paternal characteristic on maternal health service utilization.

The study used data from the most recent Ghana Demographic and Health Survey (GDHS, 2014). Both bivariate and multivariate analyses were used to investigate the effects of household wealth on the number of antenatal visits and modern contraceptive use. The bivariate analysis employed the use of chi-square test whiles, the multivariate analysis involved estimations using logistic regressions.

The findings show that household wealth would play a critical role given the revised WHO minimum ANC contacts by expectant mothers. Household wealth exerts a positive and significant effect on ANC for all wealth quintiles for women who attended at least eight ANC visits, but was insignificant for the poorer and middle quintiles of those who attended four to seven visits. Wealth, however, had an insignificant relationship with modern contraceptive use. Generally, education, age, birth order, media exposure as well as geographical locations had a significant influence on both ANC visits and modern contraceptive use. The study further revealed a heterogeneous effect on ANC attendance. In particular, despite the relatively poor conditions, women in rural areas whose partners/husbands have attained a minimum of secondary education are about twice more likely to attend 4–7 antenatal visits compared to their counterparts whose husbands/partners are without education. Hence, a holistic health education, which includes husbands/partners in the rural areas as well as strengthening interventions that improve livelihoods, is crucial.

Health guidelines are constantly reviewed, and government policies must adapt accordingly. This paper looks at the significant role household wealth still plays on modern contraceptive use and ANC visits, given the revised WHO minimum ANC contacts and uniquely underscores the influence of paternal characteristics on the utilization of these maternal health services.

Conditional Cash Transfer (CCT) aims to assist expectant mothers in low-income households. It might address the insufficient prenatal and postnatal healthcare services in rural areas of low-income nations, including Bangladesh. However, the effectiveness of such intervention is rarely investigated in rural Bangladesh. The study aims to explore the impact of CCT on certain health outcomes of expectant mothers in southwestern rural Bangladesh.

The study applied the quasi-experimental Propensity Score Matching method to assess the effectiveness of CCT in health outcomes of expectant mothers. The authors also deployed logistic regression to explore the predictors of three health issues – blood pressure, hemoglobin adequacy and morning sickness.

The Average Treatment Effect shows that the CCT program significantly improves maternal health by lowering the extent of blood pressure and morning sickness and enhancing the hemoglobin adequacy of the CCT recipient women compared to the non-recipient. The result reveals that CCT beneficiary status as well as the education and immunization are positively and significantly associated with normal blood pressure and hemoglobin adequacy. CCT is also a negative predictor of morning sickness. The study recommends to expand the coverage of the CCT program and also emphasize on the improvement of education, training and immunization for rural pregnant women.

To assist in scaling purchasing power and nutritious food for poor pregnant and lactating mothers in low-income households, “Nobojatra” project initiated the CCTs in the southwest region of Bangladesh. Yet, the impact of such cash transfers on their health outcomes is rarely explored in the context of Bangladesh. This study provides evidence regarding the effectiveness of cash transfers to pregnant women of low-income households in rural Bangladesh.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2022-0512

The purpose of this paper is to undermine the role of cellular technology, government and the funding agency to deliver reliable and cost-effective health services for the people living in the bottom of pyramid and remote areas of the country where quality healthcare facilities are not available. The people living in rural Bihar (India) have a limited education and are reluctant to visit the female healthcare centers. The Ananya Bihar project has employed volunteers from the same community and aid from the foundation and government to improve the maternity and neo-natal healthcare initially in eight districts of the state.

The study reviewed various m-health projects and m-education projects with a detailing of the Anaya Bihar Project initiated by Melinda Gates foundation and Government of Bihar, India. The study uncovers technical, operational aspects and methodology followed by Ananya. It has detailed the best practices followed by the project. The study also features the capability of mobile as a tool to reach the masses in most cost effective way.

The use of mobile application with the association from the social worker has been tremendously successful in maternity and child healthcare in the state of Bihar, India. The application includes educating the user’s about the healthcare, training for midwives, alerts related to vaccination and thereby reducing the mortality rate and improving the maternal healthcare for the people from the bottom of pyramid. The project has created awareness among the rural families and has improved the maternity healthcare in the eight districts of Bihar, India. They were also planning to expand the project in other states of India.

The study is exploratory in nature and has not involved primary data collection and statistical analysis. The study has compiled the data and information available.

The present study may be used as a reference to the organization working on mobile healthcare projects to understand the best practices of m-health project. The study also explains the role of various stakeholders (as Ananya-Bihar was a collaborative effort of Social trust, Technical experts, Network service provider, Community, State Government and the People) in the success of the project.

The study explains the role of technology for the benefit of people. In the present case mobile healthcare initiated by the foundation has been very effective in dealing with maternity healthcare in rural Bihar, where people cannot afford expensive healthcare facility. The only silver lining is increasing tele-density at the most affordable rate in the globe, with funding from NGOs and full support from government. Such types of m-healthcare projects will support the government in delivering quality healthcare to the people who are living below poverty line and deprived of basic healthcare facilities.

The study details the methodology and technical details of Ananya Mobile health care platform.

India has shown good progress in maternal health outcome indicators. However, an area for improvement is to ensure all deliveries take place in institutions under the supervision of skilled birth attendants. This paper attempts to identify the factors that affect institutional deliveries using nationally representative National Family Health Survey (NFHS) data. Further, the authors investigate the factors contributing to the wealth-based inequality in institutional deliveries.

To address the first aspect of identifying the factors associated with undergoing an institutional delivery, the authors have used logistic and multinominal logistic models. The explanatory variables are broadly socio-economic indicators of the mother and a few other household characteristics. Further, the concentration index and regression-based decomposition were used to carry out an inequality analysis in the institutional deliveries across different wealth groups.

The authors found that women belonging to poor households, backward social groups and rural areas have significantly fewer odds of undergoing an institutional delivery. Age and education level of the mother, number of antenatal visits during pregnancy and place of residence (urban/rural) have contributed to the inequality in institutional deliveries in 2005–2006. However, the inequality due to these factors went down drastically in 2015–2016.

To the best of the authors' knowledge, this study is a distinct attempt to use pooled data of the NFHS-3 [2005–2006] and NFHS-4 [2015–2016] in identifying factors contributing to a woman undergoing an institutional-based delivery. The study also decomposes the wealth-based inequality in the factors contributing to having an institutional delivery and analyses the contributions to inequality across the two time periods.

To achieve Goal 5 of the MDGs, the Government of Ghana introduced the free maternal health service system to break financial barriers of access to maternal care services. In spite of this, facility‐based deliveries continue to be low due partly to poor quality of antenatal care that prevents pregnant women from giving birth in hospitals. The aim of this study is to examine factors shaping quality of antenatal care in selected public hospitals in the country.

363 expectant mothers were randomly selected for interview. Women who have previously received antenatal care in the health facilities for at least two occasions were interviewed. Multivariate logistic regression model were computed to examine correlates of antenatal care quality.

The odds of reporting quality of antenatal care as good was higher among women aged between 30 and 34 years. Similarly women with junior/senior high education were more likely to report antenatal care quality as good. Distance to the health facilities generally influence women perception of antenatal care quality but the relative odds of reporting quality of care as good attenuated with proximity to the health facility. Five factors (pleasant interaction with providers, privacy during consultation, attentiveness of providers, adequate facilities and availability of drugs) emerged as statistically significant in explaining antenatal care quality after controlling for selected demographic variables.

Results of the study generally demonstrate the need to improve maternal services in public facilities to stimulate utilisation and facility‐based deliveries.

There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified treatment during birth contributes to a salient, under-examined aspect of women’s childbirth experiences.

We use a two-part conceptualization of dignity, respect and autonomy, to understand how birth experiences and interactions either facilitate or undermine women’s perceived dignity. Data came from the Listening-to-Mothers I survey, the first nationally representative study of postpartum women in the United States (n = 1,406). Through linear regression analysis, we separately modeled women’s perception of respectful treatment and women’s perception of medical autonomy during birth.

Overall women reported high scores for both autonomy and respect. Differences between the models emerged related primarily to the role of interventions and provider support. While women’s perceived dignity is related to elements that she brings in to the delivery room (e.g., birth knowledge, health status), much variation was explained by the medical encounter itself (e.g., type of medical interventions, pain management, nurse support, and number of staff present).

This study is cross-sectional, and required either a telephone or internet access, thus limiting the full generalizability of findings. Two findings have direct practical relevance for promoting women’s dignity in childbirth. First, the number of staff persons present during labor and birth was negatively associated with both respect and autonomy. Second, that women with high levels of knowledge about their legal rights during childbirth were more likely to report high scores on the dignity scale. Limiting staff in the delivery room and including knowledge of legal rights in childbirth education or during prenatal visits may be two mechanisms to promote dignity in birth.

These findings address an important, under-examined aspect of women’s childbirth experiences. This study investigates how different birth experiences and interactions either promote or violate childbearing women’s perception of dignity, and has significant implications for the provision of maternal healthcare. The results reinforce the importance of focusing on the socio-psychological dimensions of childbirth.