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.
Implementation of maternal health financial scheme in rural Bangladesh (PDF)
Rahman,Md.Moshiur; Rob,Ubaidur; Kibria,Tasnima
Publication date: 2009
Location: Bangladesh (Habiganj District, Sylhet Division)
Duration: 2/2007 - 9/2008
Population Council researchers:
International Centre for Reproductive Health
John Snow, Inc./DELIVER
Canadian International Development Agency