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Bhushan I et al. – Measuring maternal expenditure against 'capacity to pay' (ME–2) may be better than measuring it as a proportion of overall household expenditure when assessing financial constraints in the use of maternal services. Improving the performance of the public sector, appropriate regulation of and partnership with the private sector, and effective direct cash transfers to pregnant women in the poorest households may increase utilization of maternal services and reduce the financial distress associated with ME.

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