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Banner photo: Settlement in Bangladesh.

Demand-based Reproductive Health Commodity Project: Voucher Scheme for Poor, Rural Women to Access Pregnancy Care

Council researchers in Bangladesh tested providing financial assistance through vouchers to poor women for maternal health care.

(Top) At a voucher distribution ceremony in a local health center, A.K.M. Zafar Ullah Khan, the honorable secretary of the Ministry of Health and Family Welfare, and Ubaidur Rob, the Population Council’s country director, distributed a voucher book and coin saving box to a pregnant woman. (Bottom) After the ceremony, a service provider explained and educated women about the benefits of vouchers and how to use them. Photos: Population Council/Bangladesh

This project was supported by the financial collaboration of the Canadian International Development Agency through the United Nations Population Fund. The Population Council performed operations research with RTM International and ICDDR,B.

In Bangladesh, maternal mortality declined from more than 600 per 100,000 live births in 1980 to 322 per 100,000 in 2004. However, the country still has one of the highest maternal mortality rates in the world. Concurrently, utilization of maternal health care provided by trained service providers in Bangladesh during and after delivery is alarmingly low.

To improve utilization of maternal health care from trained service providers, Population Council researchers tested providing financial assistance through vouchers to poor women in a rural area to enable them to receive obstetric care services. A pretest/post-test design was used, and the intervention lasted nine months, from October 2007 to June 2008.

Council researchers established a mechanism to provide vouchers to poor, pregnant women to manage pregnancy and delivery-related complications. A total of 580 poor, pregnant women received maternal vouchers. Some 436 women were interviewed before and 414 after the intervention to evaluate its impact. In addition, in-depth interviews were conducted with voucher users and nonusers.

Findings suggest that with the use of vouchers institutional deliveries increased from 2.5 percent to 20 percent. Utilization of antenatal care from trained providers increased from 50 percent to 89 percent. In addition, the proportion of women receiving postnatal care services from trained providers increased from 10 percent to 59 percent.


Related projects:

Implementation of maternal health financial scheme in rural Bangladesh (PDF
Rahman,Md.Moshiur; Rob,Ubaidur; Kibria,Tasnima
Publication date: 2009


Experiences from implementation of maternal voucher scheme in rural Bangladesh 
Rahman,Md.Moshiur; Rob,Ubaidur; Kibria,Tasnima; Hena,Ismat Ara
DBRHCP Research Update (no. 5)
Publication date: 2008


Voucher scheme for poor, rural women to utilize pregnancy care 
Rahman,Md.Moshiur; Rob,Ubaidur; Kibria,Tasnima; Rahman,Md.Mostafizur
DBRHCP Research Update (no. 3)
Publication date: 2008


 

Project Stats

Location: Bangladesh (Habiganj District, Sylhet Division) 

Program(s): Reproductive Health 

Topic(s): Health care financing
Safe pregnancy, antenatal, and delivery care

Duration: 2/2007 - 9/2008

Population Council researchers:
Md. Moshiur Rahman
Ubaidur Rob

Non-Council collaborators:
International Centre for Reproductive Health
John Snow, Inc./DELIVER

Donors:
Canadian International Development Agency

What's New

  • Learn more about reproductive health vouchers by visiting the RH vouchers project page and blog maintained by Council program associate Ben Bellows. (more) (offsite link)

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