Evaluation of a voucher programme in reducing inequities in maternal health utilisation in Cambodia: a quasi-experimental study

Bajracharya, Ashish; Bellows, Benjamin; Dingle, Antonia

doi:10.1016/s0140-6736(13)61266-0

Cited by 5 publications

(4 citation statements)

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“…Although delivery costs are less expensive at the TBTC than at the hospital, continued efforts are needed to reduce costs further through the national health insurance system and to facilitate health facility access among rural families with low incomes. Voucher programs used in other settings [11,12] might be appropriate in this setting to offset the costs of facility delivery and transport.…”

Section: Discussionmentioning

confidence: 99%

Tibetan women's perspectives and satisfaction with delivery care in a rural birth center

Gipson

Gyaltsen

Gyal

et al. 2015

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 99%

Tibetan women's perspectives and satisfaction with delivery care in a rural birth center

Gipson

Gyaltsen

Gyal

et al. 2015

Intl J Gynecology & Obste

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“…[13][14][15] Although there is evidence indicating that voucher programs can increase the use of subsidized health services, there is a lack of evidence regarding the impact of the voucher on reducing inequitable utilization trends between rich and poor. 4,10,[16][17][18][19] Primary maternal health services continue to favor wealthier households in LMIC. [20][21][22] In Bangladesh, 90% of deliveries in the lowest quintile occur at home, whereas only 40% of deliveries in the highest quintile occur at home.…”

Section: Introductionmentioning

confidence: 99%

“…13–15 Although there is evidence indicating that voucher programs can increase the use of subsidized health services, there is a lack of evidence regarding the impact of the voucher on reducing inequitable utilization trends between rich and poor. 4,10,16–19…”

Section: Introductionmentioning

confidence: 99%

Improving Access to Delivery Care and Reducing the Equity Gap Through Voucher Program in Bangladesh: Evidence From Difference-in-Differences Analysis

Keya

Bellows

Rob³

et al. 2018

Int Q Community Health Educ

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To test a statistically significant change in delivery by medically trained providers following introduction of a demand-side financing voucher, a population-based quasi-experimental study was undertaken, with 3,300 mothers in 2010 and 3,334 mothers at follow-up in 2012 in government-implemented voucher program and control areas. Results found that voucher program was significantly associated with increased public health facility use (difference-in-differences (DID) 13.9) and significantly increased delivery complication management care (DID 13.2) at facility although a null effect was found in facility-based delivery increase. A subset analysis of the five well-functioning facilities showed that facility deliveries increased DID 5.3 percentage points. Quintile-based analysis of all facilities showed that facility delivery increased more than threefold in lower quintile households comparing to twofold in control sites. The program needs better targeting to the beneficiaries, ensuring available gynecologist-anesthetist pair and midwives, effective monitoring, and timely fund reimbursements to facilities.

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“…The current evidence suggests that demand-side financing vouchers for FP likely increases use of modern contraceptive methods [ 24 – 27 , 32 ]. By targeting underserved groups, vouchers ensure subsidies reach the disadvantaged and are not absorbed by those with greater access to resources [ 33 , 34 ]. In addition, vouchers can be considered as a stepping-stone toward social health insurance, for example vouchers may help governments develop their capacity to purchase health services (accreditation, pricing, contracting, quality assurance, monitoring, claims processing, and reimbursement) and to target subsidies to underserved populations.…”

Section: Discussionmentioning

confidence: 99%

Assessment of modern contraceptives continuation, switching and discontinuation among clients in Pakistan: study protocol of 24-months post family planning voucher intervention follow up

Ali¹,

Azmat²,

Hamza³

2018

BMC Health Serv Res

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BackgroundPakistan has the second highest fertility rate in South Asia and its increasing population growth presents a significant challenge for country’s path to progress and development. Modern contraceptive methods only account for a slow-rising 26% of use in Pakistan which is further lowest in the underserved areas (< 20%), with a high unmet need for family planning (20%). The David and Lucile Packard Foundation USA and Pakistan funded two operational research projects from 2012 to 2015, that employed a Demand-side Financing (DSF) approach testing the effectiveness of single and multi-purpose voucher schemes in increasing access and uptake of FP services and products among the women of two-lowest income quintiles in the Punjab province of Pakistan. The present paper presents a study protocol which intends to assess the longer term impact of these two voucher intervention programs among married women of reproductive age (MWRA) who received contraceptive services through vouchers.MethodsThis will be a mixed methods study using qualitative and quantitative approaches. A quantitative cross sectional survey will measure the contraceptive uptake among voucher users, included in the endline survey and to examine the attitudes and behaviour of women with respect to contraceptive continuation, switching and discontinuation 24 months post intervention in two districts of Chakwal and Faisalabad in Punjab province of Pakistan. Qualitative in-depth interviews will be conducted with FP service providers operating in intervention areas and with key policy makers in the public sector to examine and document the service provider perspective on sustainability on contraceptive practices and behaviour in the post project closure period within the intervention areas.DiscussionGlobally, there is almost negligible direct evidence on the assessment of longer-term impact of a demand-side financing programs using free or subsidized vouchers for family planning services especially during post-intervention period or when donor money runs out. The findings of this study will help fill the knowledge gap in the context of sustainability issues post-intervention and will provide information to policy makers to develop and plan contraceptive services in the target area to sustain the positive behaviour change in the population.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3156-0) contains supplementary material, which is available to authorized users.

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Evaluation of a voucher programme in reducing inequities in maternal health utilisation in Cambodia: a quasi-experimental study

Cited by 5 publications

References 0 publications

Tibetan women's perspectives and satisfaction with delivery care in a rural birth center

Tibetan women's perspectives and satisfaction with delivery care in a rural birth center

Improving Access to Delivery Care and Reducing the Equity Gap Through Voucher Program in Bangladesh: Evidence From Difference-in-Differences Analysis

Assessment of modern contraceptives continuation, switching and discontinuation among clients in Pakistan: study protocol of 24-months post family planning voucher intervention follow up

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