Reproductive health and maternal health vouchers
To reduce maternal mortality, we must increase poor women's access to quality reproductive health care. The Population Council is investigating an innovative strategy to pay for reproductive health services, particularly antenatal care, childbirth, and postnatal care. In some locations women can get vouchers for family planning and treatment for sexually transmitted infections (STIs). The approach, known as a voucher-and-accreditation program, differs significantly from traditional ways of expanding access to services.
Traditionally, donor agencies provide funds directly to health facilities to allow them to offer services to the poor. In this model, clients can only receive subsidized services at facilities that are funded for such purposes, and facilities receive funding whether or not clients use their services.
With voucher-and-accreditation programs, clients receive vouchers for specific services at low or no cost. They can redeem the voucher for services at any accredited facility, and facilities are paid only for the services they actually provide. Because clients have a choice about where to obtain services, facilities are motivated to improve the quality of care they provide.
The Council is studying voucher programs in Bangladesh, Cambodia, Kenya, Tanzania, and Uganda. Early results from Kenya show that women in communities exposed to the voucher program are significantly more likely than women who live in other communities to get early antenatal care, deliver at a health facility with the help of a skilled professional, receive postnatal care, and adopt a family planning method.
Voucher-contracted facilities in Kenya have used voucher revenues to make quality improvements, such as improving infrastructure, adding new staff and equipment, and maintaining supply stocks.
This research is slated to continue throughout 2012. Program managers will use final results to improve and expand the initiative nationwide in the study countries.