American Public Health Association
137th Annual Meeting & Exposition
7–11 November 2009
Utilization of quality maternal health care services through financial scheme (Abstract no. 205444)
Md. Moshiur Rahman, Ubaidur Rob, and Md. Mahabub Ul Anwar
In Bangladesh, the maternal mortality ratio (MMR) is one of the highest in the world (322/100,000). There are several underlying causes that prohibit achieving the Millennium Development Goal of reducing the MMR at 143 by the year 2015, and among them the important causes are lack of awareness, financial constraints, and unavailability of high-quality maternal health care services. Several special programs have been introduced to provide subsidized health care services to poor people in Bangladesh. Financial assistance to poor women to avail pregnancy-related services was tested in this operations research project. The overall objective of the study was to test the feasibility and effectiveness of a financial scheme (voucher) for poor rural women to improve utilization of ANC, delivery, and PNC from trained service providers. A pretest–post-test design has been utilized. The duration of the intervention was nine months. During the intervention period, 580 pregnant poor women received vouchers from the project staff. A total 436 women were interviewed before and 414 after the intervention to evaluate the impact of interventions. In-depth interviews were conducted with voucher users and nonusers. Findings suggest that institutional deliveries have increased from 2.5 percent to 20 percent. Utilization of antenatal care from trained providers has increased from 50 percent to 100 percent. Similarly, the number of women who attended postnatal care services also has increased from 36 percent to 64 percent. Findings also revealed that the proportion of physical and medical examinations during ANC visits has significantly increased during the intervention period.
At the conclusion of this session, participants will be able to: (1) understand how poor pregnant women were selected for vouchers by community people; (2) identify how the facilities were strengthened to provide high-quality maternal health care services; and (3) know the institutionalization process of financial scheme.
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