Maternal Health Care Quality Improvement in Rajasthan, India: A Series of Insights from a Development Impact Bond Verification Agent

The Utkrisht Impact Bond is a development impact bond designed to improve the quality of maternity care offered by private providers in Rajasthan, India. This collaboration between MSD for Mothers, UBS Optimus Foundation, USAID and Palladium is one of only a few active impact bonds for health in the world.

This endline report on the quality of maternal health care from the Utkrisht Development Impact Bond (DIB) includes a series of standalone briefs to enable readers to choose the specific aspect of the DIB to learn about (endnotes for each brief appear directly after the brief).

Overall, participation in the Utkrisht DIB led to quality improvements in private facilities in Rajasthan, India. Although no evaluation was conducted to assess the DIB’s direct impact, the LiST, which leverages the latest evidence linking health care practices to mortality rates and maternal health outcomes, predicts that the gains in quality for participating facilities achieved as a result of meeting the quality standards will lead to fewer maternal and neonatal deaths. With an estimated cost of $21,800 per private facility needed to improve quality, further studies on potential returns could provide more insights into whether a case could be made to implement and sustain related quality improvement efforts.

Mathematica, the independent verification agent for the Utkrisht DIB in India, developed this report sponsored by MSD for Mothers. The views, thoughts, and opinions expressed in this report belong solely to the authors and reflect their current learning and understanding at the time of dissemination. The report contents do not necessarily reflect the official policy or position of Mathematica, or any other agency or organization.