A case-control, quasi-experimental study was designed (post-test only) to investigate the effect of a performance-based incentive payment scheme on behaviours of public-sector service providers in delivering a basic package of maternal and child-health services in Egyptian primary healthcare units. The results showed significant improvements in the quality of family-planning, antenatal care, and child-care services as reported by women seen in clinics where the incentive payment scheme was in operation as measured by various indicators, including both technical and inter-personal communication content. An analysis of characteristics of the service providers and clients found no significant or meaningful differences between the study groups, and the facilities of both the study groups were essentially the same. Some findings are suggestive of other influences on behaviours of the service providers not captured by the data-collection instruments of the study. Subsequent to this study, the payment scheme has been rolled out to other districts in Egypt.

A benefit-incidence analysis was conducted for the year 2000 using various data sources including the Jordan healthcare utilization and expenditure survey 2000. The results illustrate that the poorest segment of the Jordanian population were the most likely to report sickness and seek treatment and were the main users of the Ministry of Health outpatient services. The poorest uninsured individuals were the main source of revenues generated through user fees. The targeting efficiency (i.e. total percentage of benefits received) for the poorest quintile was 33.8% compared with 4.0% in the richest quintile. The analysis demonstrates that the Jordanian government in-kind subsidy is reaching the poor.

Aim: This study seeks to investigate the factors determining the utilization of antenatal care services, the frequency of that use, and the timing of receiving antenatal care among Egyptian women utilizing a national representative data from Egypt Demographic and Health Surveys (EDHS) in 2000 and 2014. Methods: The paper estimates the logistic regression model, zero-inflated negative binomial model (ZINB), and negative binomial regression model (NB) to identify the most important determinants of antenatal health care utilization. Results: The findings indicate that the period 2000-2014 has experienced a significant increase in the use of antenatal health care services. The use of the public sector antenatal care services relative to that of the private sector has been decreasing over time. Moreover, wealth index, women's education and quality of health services play significant roles in increasing accessibility of antenatal health care services. On the other hand, women's empowerment has shown a positive effect in 2000 only. Conclusion: The study highlights the most vulnerable groups that are less likely to have access to antenatal health care services, mainly women who are less educated, poor and living in rural areas especially Upper Egypt. This certainly requires a more targeted health strategy with an equity lens.

However, the impact of the terminated pregnancy on receiving ANC increased over time. Conclusions: Further research of the determinants of antenatal health care utilization is needed, using more updated measures of women's empowerment, availability and quality of health services. In order to improve the provision of antenatal health care services, it is important to understand barriers to antenatal health care utilization. Therefore, it is advisable to collect information from women about the reasons for not receiving antenatal care.