This application proposes the evaluation of two innovative large scale programs, which were set up to decrease maternal mortality among women living below the poverty line in India. India contributes 20% of global maternal deaths and has 26% of her population living below poverty line, and continues to have one of the highest maternal mortality ratios in the world. Progress with MDG 5 in India (slow thus far) is a prerequisite to achieving the goal by 2015.Both Indian programs were started to reduce maternal deaths by promoting institutional delivery and reducing access barriers to maternal healthcare for poor women. The two large scale, state run programs operate in two large Indian provinces. Each of these programs operates through the use of different innovative demand side financing mechanisms, which are specifically aimed at improving access for vulnerable groups. One program is a conditional cash transfer paid retrospectively to the woman on delivering in an institution while the other is a targeted bursary paid prospectively to accredited healthcare providers for delivery of the woman living below poverty. All payments are made by the state. While both programs are based on similar concepts, i.e. financial incentives for the provision and utilization of care; and the participation of the private sector – there are major differences in the socioeconomic contexts in which each program operates, financing mechanisms, provider payment models and incentives, quantum of financial assistance, level of private sector involvement, all of which will have a bearing on desired maternal health outcomes. China is a proposed partner on this application, as it is able to contribute important lessons regarding rural maternal health financing programs that were studied there in FP6.No such large scale demand side financing programs for maternal health have been evaluated before. The field is fairly new and recent scientific literature has recommended robust evaluations