Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: A qualitative evaluation

Abstract

BackgroundFew studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services.MethodsA qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya.ResultsThe findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services.ConclusionsThe above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers.

Intimate partner violence, HIV, and mental health: a triple epidemic of global proportions

“…Victims of IPV were offered support in the form of reproductive health vouchers available at healthcare facilities, giving them access to medical services (including HIV care), psychological care, and social services. Results showed that there were many barriers to the uptake of these services (Njuki et al, 2012), mostly centred around a lack of general awareness by healthcare employees and patients regarding the vouchers and benefits, and also poor response from law enforcement services.…”

“…Multivariable logistic regression analyses suggested that inequitable attitudes and couple discordance were associated with higher risk of IPV. Njuki et al (2012) Kenya, women and men n ¼ 97 interviews 27 focus groups…”

Stakeholder perspectives regarding transfer of free maternity services to National Health Insurance Fund in Kenya: Implications for universal health coverage

“…The larger study used a pretest and posttest design with a comparison group. Preintervention (pre‐FMS policy) data were from a 2012 study that evaluated the effect of the reproductive health vouchers program in Kenya on health outcomes by comparing communities in voucher and comparable nonvoucher sites . The postintervention data were collected in the same communities included in the 2012 study and involved both quantitative and qualitative components.…”

“…Following the pilot, the program was expanded to one additional county (Kilifi) as well as to additional facilities in the pilot counties, and implementation continued until late 2016. The results of this initiative indicated promising opportunities for improving access, coverage, and quality for targeted low‐income beneficiaries …”

“…The results of this initiative indicated promising opportunities for improving access, coverage, and quality for targeted low-income beneficiaries. [26][27][28][29][30] Following the failure of the 2005/2006 NSHI bill, 2 years later, Kenya embarked on a process to develop a HCF strategy. A draft HCF strategy was started in 2009, but this was not finalized due to lack of effective linkages with social security sectors; limited involvement and coordination of key government departments and lack of explicit and systematic stakeholder analysis; poor communication; and limited public debate.…”