Adequacy of maternity benefits in ensuring income security during maternity leave

9 Social protection for maternity: Key policy trends and statistics Another significant vector of inequality in access to maternity health protection is household wealth. In both low- and middle-income countries, only a small fraction of women in the lowest wealth quintile have access to maternal health protection, as compared to women in the highest wealth quintile see figure 6. Such inequalities have detrimental effects on both maternal and child health, with often harmful long-term consequences for both individuals and societies. Figure 6. Inequities in access to maternal health services by wealth quintile and national income level, latest available year Notes: Inequities in access to maternal health services are measured by births attended by skilled health personnel as a percentage of total live births in the same period. Antenatal coverage is measured by the percentage of women aged 15 –49 with a live birth in a given time period who received antenatal care four or more times. Due to data limitations, it is not possible to determine the type of provider for each visit. Detailed information and definitions are available in the Excel file see link below. Global average weighted by total population UN, World Population Prospects, 2012 Revision; value for 2012. Global averages should be considered with caution owing to the small sample size. Source: ILO 2014a, based on WHO Global Health Observatory, various years. Link: http:www.social-protection.orggimigessRessourceDownload.action?ressource.ressourceId=42882 . Figure 7 illustrates the importance of providing quality maternal care services by showing the inverse correlation across countries between the percentage of births supervised by skilled birth attendants and the maternal mortality ratio. Moreover, the available evidence suggests that income security also contributes to the well- being of pregnant women, new mothers and their children. Countries that have a higher level of coverage for maternity cash benefits also tend to achieve better results with respect to maternal mortality ratios. These results call for a comprehensive approach to maternity protection, combining maternal health care and income security, and also occupational safety and health measures, as stipulated in ILO maternity protection standards. Social protection for maternity: Key policy trends and statistics 10 Figure 7. Maternal mortality ratio per 100,000 live births and live births attended by skilled health personnel, according to national income level, 2011 Note: R2 = 0.6009. Sources: ILO, 2014a, based on WHO Global Health Observatory and World Bank, World Development Indicators. Link: http:www.social-protection.orggimigessRessourceDownload.action?ressource.ressourceId=42483 .

4. Policy trends 2010-2015 in maternity cash benefits

Maternity protection is recognized globally as a crucial component of social protection systems – effectively, as an investment to secure each country’s future human capital – as shown by the number and range of recent and continuing policy initiatives. Recent policy trends in maternity protection schemes show that a number of European countries have adopted adjustment measures that effectively reduced the level of maternity protection, having a detrimental impact on women’s rights. Other countries have adopted measures that extend maternity protection by enhancing the duration and scope of maternity benefits, or by extending maternity protection coverage.

4.1 Adjustment measures reducing the level of maternity protection in several European countries

In the context of the financial and economic crisis, several countries have taken measures that have reduced the level of maternity protection see box 3. In countries including the Czech Republic, Germany, Ireland and the United Kingdom, the level of maternity benefits has been reduced. In addition, maternity benefits are now treated as taxable income in Ireland. Some of these fiscal consolidation measures have significantly reduced the level of maternity protection available to certain groups of pregnant women and new mothers. Although in some countries measures have been taken to protect the levels of protection available to those on lower incomes, other groups may still have suffered marked reductions in the benefits they receive, jeopardizing their income security during this critical period of their lives. In addition, access to maternal health care may also have suffered from cuts within the health-care system see ILO, 2014a, Chapter 5. At a time when many European governments are considering or implementing measures to encourage higher birth rates, ill-designed fiscal consolidation measures may have unintended negative effects. It is thus necessary to carefully consider the short- and long-term impacts of policy reforms in this area.