Journal articles: 'Maternal health voucher scheme'

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Das, Akkur Chandra, and Manik Nag. "The association between voucher scheme and maternal healthcare services among the rural women in Bangladesh: a cross sectional study." Bangladesh Journal of Medical Science 17, no. 4 (September 19, 2018): 545–55. http://dx.doi.org/10.3329/bjms.v17i4.38314.

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Background: Maternal health voucher scheme, providing financial support to poor women, is popularly known as subsidies in maternity care services including antenatal, delivery and postnatal care and also economic barriers while seeking treatment from qualified service providers. The aim of this study is to evaluate the association of voucher scheme on receiving maternal healthcare services among the rural women in Bangladesh.Methods: This is a cross sectional study where total sample size was (n=500) rural women who were selected by using convenience sampling method. Among them, 250 women were voucher scheme receivers and other 250 women were non-voucher scheme receivers. A structured questionnaire was adopted for data collection between November and December 2015. In the final analysis, cross tabular analysis and logistic regression model were used, and adjusted odds ratios (ORs) were reported.Results: The study found a strong relation between voucher scheme and maternal healthcare services among the rural women in Bangladesh where majority (88.4%) voucher scheme receivers received information or treatment of Reproductive Tract Infections (RTIs) and Sexually Transmitted Infections (STIs) while non-voucher scheme receivers received only 10%. Most of the respondents (93%) voucher scheme receivers received at least 3 times of antenatal care visit; but only 28% received non-voucher scheme receivers at least 3 times of antenatal care visit. Voucher scheme receivers received 17.127 times more likelihood to receive skilled birth attendance and 25.344 times more likelihood to receive institutional delivery services and positively significant (5 percent) compared to those who did not receive maternal heath voucher scheme. Moreover, 92.4% voucher receivers received transport cost and 73.2%, received safe home delivery services while 22.8% non-voucher scheme receivers received transport cost and only 20.4% received safe home delivery services. Majority (94%) voucher scheme receivers received long time birth control services while only 19.2% non-voucher scheme receivers received long time birth control services.Conclusion: Women who did not receive maternal health voucher scheme found the status of lower antenatal, delivery and postnatal care services receiving trends compared to the women who received the maternal health voucher scheme. It is recommended an effective monitoring system and necessary interventions getting overall developed health status in Bangladesh.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.545-555

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Das, Akkur Chandra. "Improving access to safe delivery for poor women by voucher scheme in Bangladesh." South East Asia Journal of Public Health 5, no. 1 (September 13, 2015): 39–43. http://dx.doi.org/10.3329/seajph.v5i1.24850.

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Maternal and child mortality are still higher in Bangladesh where delivery care services are associated with a number of problems. Demand-side financing, popularly well-known as maternal health care voucher, is found to reduce the financial barriers, increases choice for clients, and improves efficiency in delivery and quality of services which ultimately enhances maternal health. A cross-sectional study was conducted in different upzilas of Bhola district in Bangladesh among poor married women and found that voucher scheme receivers were 17.64 times more likely to receive delivery care services than respondents who were not part of the voucher scheme. On the other hand, the study pointed out that recipients of the voucher scheme received comparatively higher levels of delivery care services compared to those not in the voucher scheme, such as skilled birth attendance (64.2% vs. 26.3%), institutional delivery services (86.9% vs. 24.7%), and transport costs (92.5% vs. 23.1%). As the voucher scheme receivers delivery care services ensured better health status and care services than non-voucher scheme receivers in Bangladesh, the current study suggests that increasing the accessibility of voucher scheme programs will facilitate the provision of effective maternal health care services.South East Asia Journal of Public Health Vol.5(1) 2015: 39-43

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Schmidt, Jean-Olivier, Tim Ensor, Atia Hossain, and Salam Khan. "Vouchers as demand side financing instruments for health care: A review of the Bangladesh maternal voucher scheme." Health Policy 96, no. 2 (July 2010): 98–107. http://dx.doi.org/10.1016/j.healthpol.2010.01.008.

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Massavon, William, Calistus Wilunda, Maria Nannini, Caroline Agaro, Simon Amandi, John Bosco Orech, Emanuela De Vivo, Peter Lochoro, and Giovanni Putoto. "Community perceptions on demand-side incentives to promote institutional delivery in Oyam district, Uganda: a qualitative study." BMJ Open 9, no. 9 (September 2019): e026851. http://dx.doi.org/10.1136/bmjopen-2018-026851.

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ObjectiveTo examine the perceptions of community members and other stakeholders on the use of baby kits and transport vouchers to improve the utilisation of childbirth services.DesignA qualitative study.SettingOyam district, Uganda.ParticipantsWe conducted 10 focus group discussions with 59 women and 55 men, and 18 key informant interviews with local leaders, village health team members, health facility staff and district health management team members. We analysed the data using qualitative content analysis.ResultsFive broad themes emerged: (1) context, (2) community support for the interventions, (3) health-seeking behaviours postintervention, (4) undesirable effects of the interventions and (5) implementation issues and lessons learnt. Context regarded perceived long distances to health facilities and high transport costs. Regarding community support for the interventions, the schemes were perceived to be acceptable and helpful particularly to the most vulnerable. Transport vouchers were preferred over baby kits, although both interventions were perceived to be necessary. Health-seeking behaviours entailed perceived increased utilisation of maternal health services and ‘bypassing’, promotion of collaboration between traditional birth attendants and formal health workers, stimulation of men’s involvement in maternal health, and increased community awareness of maternal health. Undesirable effects of the interventions included increased workload for health workers, sustainability concerns and perceived encouragement to reproduce and dependency. Implementation issues included information gaps leading to confusion, mistrust and discontent, transport voucher scheme design; implementation; and payment problems, poor attitude of some health workers and poor quality of care, insecurity, and a shortage of baby kits. Community involvement was key to solving the challenges.ConclusionsThe study provides further insights into the implementation of incentive schemes to improve maternal health services utilisation. The findings are relevant for planning and implementing similar schemes in low-income countries.

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Ahmed, S., and M. M. Khan. "A maternal health voucher scheme: what have we learned from the demand-side financing scheme in Bangladesh?" Health Policy and Planning 26, no. 1 (April 7, 2010): 25–32. http://dx.doi.org/10.1093/heapol/czq015.

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Ahmed, Shakil, and M. Mahmud Khan. "Is demand-side financing equity enhancing? Lessons from a maternal health voucher scheme in Bangladesh." Social Science & Medicine 72, no. 10 (May 2011): 1704–10. http://dx.doi.org/10.1016/j.socscimed.2011.03.031.

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Tantivess, Sripen, Yot Teerawattananon, Pitsaphun Werayingyong, Pritaporn Kingkaew, Nilar Tin, SanSan Aye, and Phone Myint. "Evidence-informed policy formulation: the case of the voucher scheme for maternal and child health in Myanmar." WHO South-East Asia Journal of Public Health 3, no. 3 (2014): 285. http://dx.doi.org/10.4103/2224-3151.206751.

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Rahman, Tanzila. "Demand Side Financing and Healthcare Seeking of Pregnant Women." Journal of Clinical and Laboratory Research 5, no. 1 (January 6, 2022): 01–04. http://dx.doi.org/10.31579/2768-0487/058.

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Demand-side financing (DSF) scheme is popularly known as the maternal health voucher program, which is launched in many developing countries of the world including Bangladesh as an intervention of developing overall health status. Maternal mortality ratio is a strong indicator of health profile of any country and pregnant women are prone to fall vulnerable situation. This review was aimed to find gap/missing of existing literature in order to make foundation of new research on healthcare seeking of pregnant women along with financing coverage. After repeated critical review of number original articles, some gaps have been found. Almost every article they focused on outcome and mildly highlighted input variables but did not consider all possible variables and missed to show interlink between those variables.

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Ahmed, Sayem, Md Zahid Hasan, Nausad Ali, Mohammad Wahid Ahmed, Emranul Haq, Sadia Shabnam, Morseda Chowdhury, et al. "Effectiveness of health voucher scheme and micro-health insurance scheme to support the poor and extreme poor in selected urban areas of Bangladesh: An assessment using a mixed-method approach." PLOS ONE 16, no. 11 (November 1, 2021): e0256067. http://dx.doi.org/10.1371/journal.pone.0256067.

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Background National healthcare financing strategy recommends tax-based equity funds and insurance schemes for the poor and extreme poor living in urban slums and pavements as the majority of these population utilise informal providers resulting in adverse health effects and financial hardship. We assessed the effect of a health voucher scheme (HVS) and micro-health insurance (MHI) scheme on healthcare utilisation and out-of-pocket (OOP) payments and the cost of implementing such schemes. Methods HVS and MHI schemes were implemented by Concern Worldwide through selected NGO health centres, referral hospitals, and private healthcare facilities in three City Corporations of Bangladesh from December 2016 to March 2020. A household survey with 1,294 enrolees, key-informant interviews, focus group discussions, consultative meetings, and document reviews were conducted for extracting data on healthcare utilisation, OOP payments, views of enrolees, and suggestions of implementers, and costs of services at the point of care. Results Healthcare utilisation including maternal, neonatal and child health (MNCH) services, particularly from medically trained providers, was higher and OOP payments were lower among the scheme enrolees compared to corresponding population groups in general. The beneficiaries were happy with their access to healthcare, especially for MNCH services, and their perceived quality of care was fair enough. They, however, suggested expanding the benefits package, supported by an additional workforce. The cost per beneficiary household for providing services per year was €32 in HVS and €15 in MHI scheme. Conclusion HVS and MHI schemes enabled higher healthcare utilisation at lower OOP payments among the enrolees, who were happy with their access to healthcare, particularly for MNCH services. However, they suggested a larger benefits package in future. The provider’s costs of the schemes were reasonable; however, there are potentials of cost containment by purchasing the health services for their beneficiaries in a competitive basis from the market. Scaling up such schemes addressing the drawback would contribute to achieving universal health coverage.

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Gideon, Jasmine, Benjamin M. Hunter, and Susan F. Murray. "Public-private partnerships in sexual and reproductive healthcare provision: establishing a gender analysis." Journal of International and Comparative Social Policy 33, no. 2 (June 2017): 166–80. http://dx.doi.org/10.1080/21699763.2017.1329157.

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Abstract The past few decades have seen the growing popularity of public-private partnerships (PPPs) across the health sector – a catch all term used to encompass diverse activities involving both public and private sector entities in areas of global and domestic health. In the article we consider the factors that have led to this proliferation of PPPs in the healthcare delivery field and consider the link to the process of ‘scientization’ of healthcare. With a focus on sexual and reproductive health the article also considers two commonly used mechanisms employed in SRH service delivery that have been used in PPPs – social franchise and health voucher schemes. We then reprise key points from the existing critical literature on gendered health systems and go on to consider their application to such service provision-oriented PPPs, using an exploratory analysis of a case study of the use of maternal health vouchers in India.

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Dabak, Saudamini Vishwanath, Yot Teerawattananon, and Thiri Win. "From Design to Evaluation: Applications of Health Technology Assessment in Myanmar and Lessons for Low or Lower Middle-Income Countries." International Journal of Technology Assessment in Health Care 35, no. 6 (2019): 461–66. http://dx.doi.org/10.1017/s0266462319000199.

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AbstractObjectivesHealth technology assessment (HTA) has been widely used to inform coverage decisions in high-income countries over the past few decades and has been getting increasing attention in middle-income countries as a tool for healthcare decision making in recent years. This study aims to use the case of the Maternal and Child Health Voucher Scheme (MCHVS) in Myanmar to understand how HTA can have a policy impact in a low or lower middle-income country.MethodsThe stages heuristic framework was used to describe the policy-making process. A document review was conducted and tacit knowledge of researchers involved was recorded.ResultsThe opportunity for a grant propelled maternal and child health to the policy agenda. An ex-ante HTA, which included a model-based health economic evaluation, informed the design of the scheme. The framework and key parameters from the ex-ante HTA were used for a mid-term review, which provided feedback to the policy implementation process. An ex-post HTA involved fielding a household survey to assess the impact of the scheme.ConclusionsHTA can be a useful method for informing resource allocation throughout the policy process in low and lower middle-income settings where no formal mechanism for making coverage decisions exists.

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Kingkaew, Pritaporn, Pitsaphun Werayingyong, San San Aye, Nilar Tin, Alaka Singh, Phone Myint, and Yot Teerawattananon. "An ex-ante economic evaluation of the Maternal and Child Health Voucher Scheme as a decision-making tool in Myanmar." Health Policy and Planning 31, no. 4 (September 26, 2015): 482–92. http://dx.doi.org/10.1093/heapol/czv090.

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Nandi, Arijit, Thomas J. Charters, Amm Quamruzzaman, Erin C. Strumpf, Jay S. Kaufman, Jody Heymann, Arnab Mukherji, and Sam Harper. "Health care services use, stillbirth, and neonatal and infant survival following implementation of the Maternal Health Voucher Scheme in Bangladesh: A difference-in-differences analysis of Bangladesh Demographic and Health Survey data, 2000 to 2016." PLOS Medicine 19, no. 8 (August 15, 2022): e1004022. http://dx.doi.org/10.1371/journal.pmed.1004022.

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Background Starting in 2006 to 2007, the Government of Bangladesh implemented the Maternal Health Voucher Scheme (MHVS). This program provides pregnant women with vouchers that can be exchanged for health services from eligible public and private sector providers. In this study, we examined whether access to the MHVS was associated with maternal health services utilization, stillbirth, and neonatal and infant mortality. Methods and findings We used information on pregnancies and live births between 2000 to 2016 reported by women 15 to 49 years of age surveyed as part of the Bangladesh Demographic and Health Surveys. Our analytic sample included 23,275 pregnancies lasting at least 7 months for analyses of stillbirth and between 15,125 and 21,668 live births for analyses of health services use, neonatal, and infant mortality. With respect to live births occurring prior to the introduction of the MHVS, 31.3%, 14.1%, and 18.0% of women, respectively, reported receiving at least 3 antenatal care visits, delivering in a health institution, and having a skilled birth attendant at delivery. Rates of neonatal and infant mortality during this period were 40 and 63 per 1,000 live births, respectively, and there were 32 stillbirths per 1,000 pregnancies lasting at least 7 months. We applied a difference-in-differences design to estimate the effect of providing subdistrict-level access to the MHVS program, with inverse probability of treatment weights to address selection into the program. The introduction of the MHVS program was associated with a lagged improvement in the probability of delivering in a health facility, one of the primary targets of the program, although associations with other health services were less evident. After 6 years of access to the MHVS, the probabilities of reporting at least 3 antenatal care visits, delivering in a health facility, and having a skilled birth attendant present increased by 3.0 [95% confidence interval (95% CI) = −4.8, 10.7], 6.5 (95% CI = −0.6, 13.6), and 5.8 (95% CI = −1.8, 13.3) percentage points, respectively. We did not observe evidence consistent with the program improving health outcomes, with probabilities of stillbirth, neonatal mortality, and infant mortality decreasing by 0.7 (95% CI = −1.3, 2.6), 0.8 (95% CI = −1.7, 3.4), and 1.3 (95% CI = −2.5, 5.1) percentage points, respectively, after 6 years of access to the MHVS. The sample size was insufficient to detect smaller associations with adequate precision. Additionally, we cannot rule out the possibility of measurement error, although it was likely nondifferential by treatment group, or unmeasured confounding by concomitant interventions that were implemented differentially in treated and control areas. Conclusions In this study, we found that the introduction of the MHVS was positively associated with the probability of delivering in a health facility, but despite a longer period of follow-up than most extant evaluations, we did not observe attendant reductions in stillbirth, neonatal mortality, or infant mortality. Further work and engagement with stakeholders is needed to assess if the MHVS has affected the quality of care and health inequalities and whether the design and eligibility of the program should be modified to improve maternal and neonatal health outcomes.

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Noor, Forhana R., Noorunnabi M. Talukder, and Ubaidur Rob. "Effect of a maternal health voucher scheme on out-of-pocket expenditure and use of delivery care services in rural Bangladesh: a prospective controlled study." Lancet 382 (October 2013): 20. http://dx.doi.org/10.1016/s0140-6736(13)62181-9.

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Kamal, S. M. Mostafa, Md Amanat Ullah, Masoumeh Tadayoni, Shahreen Noor, and Md Anisur Rahman. "Multidimensional Socioeconomic Deprivations of Maternal Health Care Services Utilisation: Evidence from Bangladesh." Pakistan Journal of Women's Studies: Alam-e-Niswan 27, no. 2 (December 31, 2020): 15–33. http://dx.doi.org/10.46521/pjws.027.02.0076.

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This paper examines the combined effect of three socioeconomic deprivations: education, wealth, and health on the utilisation of maternal health care services (MHCSs) among Bangladeshi women using the data of Bangladesh Demographic and Health Survey 2014. Both bivariate and multivariate statistical analyses were employed in this study. Multivariable logistic regression analysis is used to examine the effect of the multidimensional socioeconomic deprivations on the use of MHCSs. Of the women who had given at least one live birth in the three years preceding the survey, 43% were non-deprived by any dimension; 31% were deprived in one, 20% in two and 6% in all three dimensions. The prevalence of receiving four or more antenatal care (ANC) services was 31%; 38% used facility-based delivery (FBD) and 42% sought skilled birth assistance (SBA). When education and wealth deprivations were combined, women were significantly (P<0.01) least likely to seek assistance from SBA (OR=0.18, 95% CI: 0.14-0.24) and FBD (OR=0.17, 95% CI: 0.12-0.22); and when all three deprivations were combined women were less likely to receive ANC at least once (OR=0.16, 95% CI: 0.12-0.22) than those who were not deprived. Programmes should be undertaken to expand maternal health voucher schemes in more sub-districts and quality of care should be ensured for equal accessibility and availability of MHCSs targeting deprived and disadvantaged areas and women to ensure safe motherhood practices in Bangladesh. Our findings show that the situation of maternal health care in Bangladesh is not satisfactory.Antenatal care

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Dalinjong, Philip Ayizem, Alex Y. Wang, and Caroline S. E. Homer. "Challenges and Suggestions to Promote Maternal Service Provision and Utilization Under the Free Maternal Health Policy in Ghana: Perspectives of Health Directors and Facility Managers." International Journal of Childbirth 12, no. 1 (March 1, 2022): 4–14. http://dx.doi.org/10.1891/ijc-2021-0014.

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INTRODUCTIONTo promote service uptake and reduce maternal deaths, a policy was implemented under Ghana’s National Health Insurance Scheme in 2008. This study explored the benefits and limitations of the policy, health system challenges, and community-level challenges resulting in suggestions to mitigate the challenges.METHODSThe study design was cross-sectional, utilizing qualitative data collection. It was carried out in the Kassena-Nankana East Municipality, Ghana, involving in-depth interviews (IDIs) with directors of Ghana Health Service and facility managers. A total of eight IDIs were conducted. Data were transcribed, read, and analyzed based on themes which were presented using key quotes.RESULTSThe policy promoted the use of services. Nonetheless, challenges existed as a result of limited service coverage, inadequate human resources and infrastructure, lack of medications and equipment, lack of transport, and the influence of religion, culture, and family members. There was a need to strategize so that women with a low socioeconomic status would receive service over those of a high socioeconomic status. Other suggestions included the inclusion of family planning services, accreditation of private facilities, provision of a shift system for specialists to move to rural areas, and provision of incentives for health personnel in rural areas. It was also suggested that health personnel make known their challenges as well as to provide education on women’s rights and service expectations. The provision of transport vouchers to women as well as alternative arrangements to be made with private transport owners were also suggested.CONCLUSIONImplementing the suggestions may improve service provision and utilization leading to the reduction of maternal deaths and contributing towards achieving universal health coverage.

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Iqbal, Meesha, Anam Shahil Feroz, Khalid Siddeeg, Karima Gholbzouri, Jamela Al-Raiby, Nilmini Hemachandra, Sarah Saleem, and Sameen Siddiq. "Engagement of private healthcare sector in reproductive, maternal, newborn, child and adolescent health in selected Eastern Mediterranean countries." Eastern Mediterranean Health Journal 28, no. 9 (September 29, 2022): 638–48. http://dx.doi.org/10.26719/emhj.22.057.

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Background: The private healthcare sector in the Eastern Mediterranean Region (EMR) is active and growing, providing curative, preventive, and promotive services related to reproductive, maternal, newborn, child, and adolescent health (RMNCAH). Aims: To understand the contribution of formal for-profit private health-care sector in delivering RMNCAH services and explore best practices for improvement. Methods: Desk review of available literature from Saudi Arabia, Oman, Iraq, Egypt, Sudan, Yemen, Pakistan, and Islamic Republic of Iran, followed by stakeholder interviews in Iraq, Pakistan, and Oman were carried out. Directed content analysis using Maxqda 2020 was performed, and information was triangulated according to a priori themes: governance, health information systems, financing, and service delivery related to RMNCAH. Results: Formal and informal public–private partnerships exist in RMNCAH but lack a strategic roadmap to guide collaboration. The private healthcare sector is minimally represented in the main policy stream at national and subnational levels due to resistance from the private and public sectors. They are weak in collecting, maintaining, and sharing health information. Data on abortion and postabortion complications are scarce. Various models of supply and demand financing (voucher schemes, private and social health insurance) related to antenatal care and contraception have been implemented in the EMR. Despite the higher cost of care in the private sector, limited training of providers, ill-defined service delivery packages, and lack of continuity-of-care and team-based approaches, the private sector remains the predominant sector providing RMNCAH services in the EMR. Conclusion: Partnering with the private sector has huge untapped potential that should be harnessed by national governments for expanding RMNCAH services and progressing towards Universal Health Coverage.

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Ho, Cheryl C. W., and Tommy K. C. Ng. "Improvement of Elderly Health Care Voucher Scheme in Hong Kong." Asia Pacific Journal of Health Management 15, no. 2 (May 21, 2020): S18–22. http://dx.doi.org/10.24083/apjhm.v15i2.387.

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Elderly Health Care Voucher Scheme is a financial support provided by the government to the elderly for having more choices in selecting private primary health care services. It has been launched for more than ten years (including pilot scheme). The success of the voucher depends on its effectiveness so that Hong Kong elderly can benefit from it. The aim of this article is to analyse whether the voucher scheme has achieved its goals and what improvement can be made. The scheme is successful in encouraging the elderly to use private primary care, considering that the participation rate of the scheme is high, and elderly could use private health care services to supplement public health care services. Yet, the amount of the subsidy is insufficient to support the needs of the elderly and the providers of the voucher are not enough for Hong Kong elderly. Also, it is found that private health care services give the old generation an impression of expensiveness and unreliable even with the support of the Health Care Voucher. To improve the Elderly Health Care Voucher Scheme and solve the problems, the government should increase the amount of the voucher, set standards for regular monitoring, cooperate with private health care providers and invite more providers. Ultimately, the elderly would enjoy greater flexibility in choosing medical services in meeting their needs and the scheme can effectively achieve its purpose.

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Lee, Seohyun, and Abdul-jabiru Adam. "Designing a Logic Model for Mobile Maternal Health e-Voucher Programs in Low- and Middle-Income Countries: An Interpretive Review." International Journal of Environmental Research and Public Health 19, no. 1 (December 28, 2021): 295. http://dx.doi.org/10.3390/ijerph19010295.

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Despite the increasing transition from paper vouchers to mobile e-vouchers for maternal health in low- and middle-income countries, few studies have reviewed key elements for program planning, implementation, and evaluation. To bridge this gap, this study conducted an interpretive review and developed a logic model for mobile maternal health e-voucher programs. Pubmed, EMBASE, and Cochrane databases were searched to retrieve relevant studies; 27 maternal health voucher programs from 84 studies were identified, and key elements for the logic model were retrieved and organized systematically. Some of the elements identified have the potential to be improved greatly by shifting to mobile e-vouchers, such as payment via mobile money or electronic claims processing and data entry for registration. The advantages of transitioning to mobile e-voucher identified from the logic model can be summarized as scalability, transparency, and flexibility. The present study contributes to the literature by providing insights into program planning, implementation, and evaluation for mobile maternal health e-voucher programs.

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Dennis, Mardieh L., Timothy Abuya, Oona Maeve Renee Campbell, Lenka Benova, Angela Baschieri, Matteo Quartagno, and Benjamin Bellows. "Evaluating the impact of a maternal health voucher programme on service use before and after the introduction of free maternity services in Kenya: a quasi-experimental study." BMJ Global Health 3, no. 2 (May 2018): e000726. http://dx.doi.org/10.1136/bmjgh-2018-000726.

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IntroductionFrom 2006 to 2016, the Government of Kenya implemented a reproductive health voucher programme in select counties, providing poor women subsidised access to public and private sector care. In June 2013, the government introduced a policy calling for free maternity services to be provided in all public facilities. The concurrent implementation of these interventions presents an opportunity to provide new insights into how users adapt to a changing health financing and service provision landscape.MethodsWe used data from three cross-sectional surveys to assess changes over time in use of 4+ antenatal care visits, facility delivery, postnatal care and maternal healthcare across the continuum among a sample of predominantly poor women in six counties. We conducted a difference-in-differences analysis to estimate the impact of the voucher programme on these outcomes, and whether programme impact changed after free maternity services were introduced.ResultsBetween the preintervention/roll-out phase and full implementation, the voucher programme was associated with a 5.5% greater absolute increase in use of facility delivery and substantial increases in use of the private sector for all services. After free maternity services were introduced, the voucher programme was associated with a 5.7% higher absolute increase in use of the recommended package of maternal health services; however, disparities in access to facility births between voucher and comparison counties declined. Increased use of private sector services by women in voucher counties accounts for their greater access to care across the continuum.ConclusionsOur findings show that the voucher programme is associated with a modest increase in women’s use of the full continuum of maternal health services at the recommended timings after free maternity services were introduced. The greater use of private sector services in voucher counties also suggests that there is need to expand women’s access to acceptable and affordable providers.

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Huang, Junjie, Chun-Ho Ngai, Man-Sing Tin, Qingjie Sun, Pamela Tin, Eng-Kiong Yeoh, and Martin C. S. Wong. "Healthcare Voucher Scheme for Screening of Cardiovascular Risk Factors: A Population-Based Study." International Journal of Environmental Research and Public Health 18, no. 20 (October 15, 2021): 10844. http://dx.doi.org/10.3390/ijerph182010844.

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The present study aimed to evaluate the factors associated with unwillingness to join a healthcare voucher scheme for screening of cardiovascular risk factors in a Chinese population. We conducted a telephone survey by random selection of 1200 subjects who were aged 45 years or above in Hong Kong. We collected data on their attitude, perception, and perceived feasibility of a healthcare voucher scheme. The overall rates of having received at least one type, two types, and all three types of screening tests are 81.1%, 80.7%, and 79.3%, respectively. Younger individuals (aOR = 0.338, p = 0.004), those of a higher educational level (aOR = 1.825, p = 0.006), being employed (aOR = 3.030, p = 0.037), and lower perception of screening as beneficial (aOR = 0.495, p < 0.001) were significantly associated with no regular screening for at least one medical condition. The overall rate of willingness to join the voucher scheme (among those aged ≥ 45) is 83.7%. Male sex (aOR = 2.049, p = 0.010) and absence of family history of cardiovascular disease (aOR = 0.362, p = 0.002) are independent predictors of unwillingness to join. Our findings highlighted the significance of sex and family history on screening of cardiovascular factors. These constructs and independent predictors identified provide evidence-based formulation and implementation targeted screening strategies that enhance the screening rate of the three cardiovascular risk factors.

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Chong, KC, H. Fung, and EK Yeoh. "Improving Hong Kong’s Elderly Health Care Voucher Scheme: an overview and update." Hong Kong Medical Journal 25, no. 6 (December 4, 2019): 494–96. http://dx.doi.org/10.12809/hkmj187633.

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Nguyen, Ha T. H., Laurel Hatt, Mursaleena Islam, Nancy L. Sloan, Jamil Chowdhury, Jean-Olivier Schmidt, Atia Hossain, and Hong Wang. "Encouraging maternal health service utilization: An evaluation of the Bangladesh voucher program." Social Science & Medicine 74, no. 7 (April 2012): 989–96. http://dx.doi.org/10.1016/j.socscimed.2011.11.030.

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Watt, Claire, Timothy Abuya, Charlotte E. Warren, Francis Obare, Lucy Kanya, and Ben Bellows. "Can Reproductive Health Voucher Programs Improve Quality of Postnatal Care? A Quasi-Experimental Evaluation of Kenya’s Safe Motherhood Voucher Scheme." PLOS ONE 10, no. 4 (April 2, 2015): e0122828. http://dx.doi.org/10.1371/journal.pone.0122828.

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TORTOSA, MARIA ANGELES, and RAFAEL GRANELL. "Nursing home vouchers in Spain: the Valencian experience." Ageing and Society 22, no. 6 (November 2002): 669–87. http://dx.doi.org/10.1017/s0144686x02008942.

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The main purpose of this paper is to evaluate the innovative nursing home voucher scheme that was introduced by the Valencia Autonomous Region of Spain in the early 1990s to implement targets laid down by the national plan for the development of older people's services. The article begins with a review of the evolution of Spanish social services, and especially the nursing home sector, and then summarises the genesis, objectives and characteristics of the voucher scheme. The main part of the paper reports a performance analysis and economic evaluation of the programme. On the basis of detailed information over four years, it is concluded that nursing home vouchers have contributed to the increased supply of publicly-financed rooms, have promoted equality of access to the service, and have increased user choice. It is also shown, however, that while vouchers can lead to an increase in the quality of inputs, they increase utilisation and expenditure. In the absence of the monitoring or reporting data that would be required, it is not possible to determine whether the scheme has increased efficiency, in the sense of improving the quality of life of frail older people at reasonable and containable cost.

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Osei-Akoto, Isaac, Ama Pokuaa Fenny, Clement Adamba, and Dela Tsikata. "Client Power and Access to Quality Health Care: An Assessment of Ghana's Health Insurance Scheme." Journal of African Development 15, no. 1 (April 1, 2013): 73–97. http://dx.doi.org/10.5325/jafrideve.15.1.0073.

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Abstract Ghana's health service delivery is characterized by inadequate institutions and lack of accountability. One of the reasons for the introduction of the National Health Insurance Scheme (NHIS) in Ghana was to facilitate citizen participation and ownership of the health service delivery system. Yet, this aspect of the scheme has often been overlooked. We examine how the NHIS and its related institutions perform the role of public oversight over frontline providers to ensure quality services. The main findings are: (i) there is improvement in the purchasing power of clients (policyholders use insurance card as a purchasing voucher to seek health care);(ii) competition among frontline providers generated by the National Health Insurance Authority's accreditation procedures ensures institutionalization of quality services for clients; and (iii) related institutions under the scheme, educate and mobilize the people and build up communal power which ensures that communities act jointly to demand quality services. We conclude that creating institutional space for direct participation of users and citizens in general is a robust means of concurrently empowering citizens and providing an avenue by which providers may be sanctioned, thus making them more responsive to users.

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Alfonso, Y. Natalia, David Bishai, John Bua, Aloysius Mutebi, Crispus Mayora, and Elizabeth Ekirapa-Kiracho. "Cost-effectiveness analysis of a voucher scheme combined with obstetrical quality improvements: quasi experimental results from Uganda†." Health Policy and Planning 30, no. 1 (December 25, 2013): 88–99. http://dx.doi.org/10.1093/heapol/czt100.

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Wu, Y., EK Yeoh, HK Yam, EL Wong, and VL Fung. "A Longitudinal Study on Elders’ Awareness, Usage, Attitudes, and Choice of Doctors in Hong Kong Elderly Healthcare Voucher Scheme." Value in Health 21 (September 2018): S60. http://dx.doi.org/10.1016/j.jval.2018.07.455.

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Mahmood, Shehrin Shaila, Mark Amos, Shahidul Hoque, Mohammad Nahid Mia, Asiful Haidar Chowdhury, Syed Manzoor Ahmed Hanifi, Mohammad Iqbal, William Stones, Saseendran Pallikadavath, and Abbas Bhuiya. "Does healthcare voucher provision improve utilisation in the continuum of maternal care for poor pregnant women? Experience from Bangladesh." Global Health Action 12, no. 1 (January 1, 2019): 1701324. http://dx.doi.org/10.1080/16549716.2019.1701324.

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Eram, Uzma. "Review article on utilization and perception of health services under Janani Suraksha Yojna among mothers." International Journal Of Community Medicine And Public Health 4, no. 4 (March 28, 2017): 891. http://dx.doi.org/10.18203/2394-6040.ijcmph20171303.

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Janani Suraksha Yojana (JSY) is the name in Hindi language that literally means “maternal protection scheme. Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Health Mission (NHM). Earlier it was known as National Rural Health Mission (NRHM) it is being implemented with the objective of reducing maternal and neonatal mortality by promoting institutional delivery among poor pregnant women. The scheme is under implementation in all states and union territories, with a special focus on low performing states. The scheme seeks to reduce maternal and neo-natal mortality by promoting institutional delivery, that is, by providing a cash incentive to mothers who deliver their babies in a health facility. There is also provision for incentives to Accredited Social Health Activists (ASHA) for encouraging mothers to go for institutional delivery. The scheme is fully sponsored by the Central Government and is implemented in all states and Union Territories, with special focus on low performing states like Uttar Pradesh.

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Filipe, Rita, and Pedro Aguiar. "Saúde Oral - Fatores de Não Adesão aos Cheques-Dentista: Um Estudo de Caso-Controlo." Acta Médica Portuguesa 31, no. 6 (June 29, 2018): 303. http://dx.doi.org/10.20344/amp.9640.

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Introduction: A dental voucher was created to facilitate the access to oral health care, however the use of these vouchers, by students aged 7, 10 and 13 with dental caries from state schools within the geodemographic area covered by the Community Health Center Group of Western Lisbon and Oeiras, had a low uptake (23%, school year 2014/2015) The aim of this study was to examine the factors associated with this non-use.Material and Methods: A case-control study was carried out involving 270 students (135 cases and 135 controls) from 35 state schools who agreed to participate in the study. A descriptive analysis of the reasons for non-adhesion to the voucher, and a study associating the variables and the use/non-use of the dental vouchers using bivariate and multivariate statistical analysis was made adopting a significance of 0.05.Results: The main reasons for non-use (n = 135) were the use of private dentists outside the dental voucher scheme (23.7%) and forgetting to use the vouchers or exceeding the expiry date (21.5%). The main factor associated with the non-use was students having a private dentist (OR adjusted 2.004, p = 0.012; IC 95%: 1.176 – 3.413) and the main factor associated with the use was having information of dentists accepting dental vouchers (OR adjusted 0.096, p = < 0.001; IC 95%: 0.047 – 0.198).Discussion: Our findings highlight the need to improve the accessibility to dental vouchers.Conclusion: It is hoped that the identification of these factors will contribute in the planning of strategies and activities to improve the use of dental vouchers.

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Angioha, Pius U., Thomas A. Omang, Uduakobong P. Akpabio, James A. Ogar, Tersoo Asongo, and Francis Ibioro. "Improving Access to Maternal Healthcare Among Female Employees: Quantitative Analysis of the impact of The National Health Insurance Scheme." SAINSMAT: Journal of Applied Sciences, Mathematics, and Its Education 10, no. 1 (March 31, 2021): 35–42. http://dx.doi.org/10.35877/sainsmat1012112021.

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This study examines the correlation between the national health insurance scheme and access to national health care among female employees in Federal Institutions in Calabar cross river state, Nigeria. The study specifically examines the extent to which the national health insurance scheme reduces the cost of health and Enrollment in the NHIS relates to access to maternal healthcare. Two hypotheses were raised for the study. The survey research design was adopted in collecting data from 400 samples from a population of 9201 female employees of the federal institutions in Calabar cross river state. The instrument of data collection was the questionnaire. Data collected was analyzed using descriptive and correlation analysis. Results revealed that the national health insurance scheme reduced health cost relates to access to maternal healthcare. Results also indicated that Enrollment in NHIS significantly relates to access to maternal health. Based on this result, the study recommends, amongst others, that there is a need for government to improve on health funding as this will help improve access to various provisions of the scheme as it relates to maternal health

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Bajracharya, Ashish, Ben Bellows, and Antonia Dingle. "Evaluation of a voucher programme in reducing inequities in maternal health utilisation in Cambodia: a quasi-experimental study." Lancet 381 (June 2013): S12. http://dx.doi.org/10.1016/s0140-6736(13)61266-0.

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Bellows, B., C. Kyobutungi, M. K. Mutua, C. Warren, and A. Ezeh. "Increase in facility-based deliveries associated with a maternal health voucher programme in informal settlements in Nairobi, Kenya." Health Policy and Planning 28, no. 2 (March 21, 2012): 134–42. http://dx.doi.org/10.1093/heapol/czs030.

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Borghi, Josephine, Anna Gorter, Peter Sandiford, and Zoyla Segura. "The cost-effectiveness of a competitive voucher scheme to reduce sexually transmitted infections in high-risk groups in Nicaragua." Health Policy and Planning 20, no. 4 (July 1, 2005): 222–31. http://dx.doi.org/10.1093/heapol/czi026.

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Gingrich, Chris D., Kara Hanson, Tanya Marchant, Jo-Ann Mulligan, and Hadji Mponda. "Price subsidies and the market for mosquito nets in developing countries: A study of Tanzania’s discount voucher scheme." Social Science & Medicine 73, no. 1 (July 2011): 160–68. http://dx.doi.org/10.1016/j.socscimed.2011.04.028.

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Tami, Adriana, Juliet Mbati, Rose Nathan, Haji Mponda, Christian Lengeler, and Joanna RM Armstrong Schellenberg. "Use and misuse of a discount voucher scheme as a subsidy for insecticide-treated nets for malaria control in southern Tanzania." Health Policy and Planning 21, no. 1 (November 21, 2005): 1–9. http://dx.doi.org/10.1093/heapol/czj005.

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Bonfrer, Igna, Lyn Breebaart, and Ellen Van de Poel. "The Effects of Ghana’s National Health Insurance Scheme on Maternal and Infant Health Care Utilization." PLOS ONE 11, no. 11 (November 11, 2016): e0165623. http://dx.doi.org/10.1371/journal.pone.0165623.

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Chan, Alice, Manisha Tamrakar, Katherine Leung, Chloe Jiang, Edward Lo, and Chun-Hung Chu. "Oral Health Care of Older Adults in Hong Kong." Geriatrics 6, no. 4 (October 8, 2021): 97. http://dx.doi.org/10.3390/geriatrics6040097.

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The older adult population is increasing both in number and in proportion worldwide. In Hong Kong, the number of people aged 65 or above is expected to reach 2.5 million in 2039, thus becoming one-third of the population. With this growing population, the need for dental care among older adults is expected to surge. Oral health care is one of the government’s core policy agendas and the Department of Health has emphasised its importance. It has implemented a number of policies, such as increasing the number of dental training places, setting up an expert group for oral health care policy planning, and conducting regular oral health surveys of the population. It is subsidizing several programmes, including the Elderly Health Care Voucher Scheme, Community Care Fund Elderly Dental Assistance Programme, Outreach Dental Care Programme, and Comprehensive Social Security Assistance Programme, in order to promote oral health care in older adults. These programmes have received support and positive feedback from both the public and dental service providers. The purpose of this review is to provide an overview of the oral health care of older adults in Hong Kong and recommendations to enhance their effectiveness.

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Patel, Dr Arti J., and Dr Hardik P. Chauhan. "Maternal Health Beneficiary Scheme: Impact on Emergency Referred Cases at Tertiary Referral Hospital." International Journal of Scientific Research 2, no. 2 (June 1, 2012): 315–18. http://dx.doi.org/10.15373/22778179/feb2013/106.

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Omobowale, O., and O. Omobowale. "SP6-70 National Health Insurance Scheme, MDG and maternal and child health in Oyo State, Nigeria." Journal of Epidemiology & Community Health 65, Suppl 1 (August 1, 2011): A473. http://dx.doi.org/10.1136/jech.2011.142976q.41.

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Haaren, Paula, and Stefan Klonner. "Lessons learned? Intended and unintended effects of India's second‐generation maternal cash transfer scheme." Health Economics 30, no. 10 (July 18, 2021): 2468–86. http://dx.doi.org/10.1002/hec.4390.

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Ahuru, Rolle Remi, Osaze Daniel, and Henry Akpojubaro Efegbere. "The influence of health insurance enrolment on maternal and childcare use in Nigeria." Social Work and Social Welfare 3, no. 1 (2021): 82–90. http://dx.doi.org/10.25082/swsw.2021.01.001.

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Purpose Health insurance reduces the cost of using modern maternal and child cares and encourages women to use modern care services. This is because health insurance scheme spread the burden of maternal care usage across people and overtime. In Nigeria, there is a dearth of research evidence on the effect of health insurance enrolment on maternal and childcare use. This study examined the effect of health insurance coverage on maternal and childcare use in Nigeria, drawing upon data from the most recent National Demographic and Health Survey (2018). Methods Three outcome indicators were used: a minimum of four antenatal care (ANC) visits, place of delivery, and complete child immunization. Descriptive and predictive analytical methods were utilized. A representative sample of 33,715 women who reported recent birth within the last five years preceding the Survey was used for the analyses. Analyses were undertaken using STATA version 13.0 for windows. Results The results showed that 57% of the women made a minimum of four ANC visits, 41% delivered in health institutions, and 27% undertook complete child immunization. Enrolment in health insurance was low as only 2.3% of the women were under any form of health insurance coverage. However, enrolment in health insurance significantly improves the odds for a minimum of four ANC visits [aOR: 1.52, p = 0.00] and health facility delivery [aOR: 1.42, p = 0.00]. However, there is no significant difference in complete child immunization between women who were under health insurance and those who were not [aOR: 1.36, p = 0.28]. Also, residing in an urban area, Southern geopolitical zones, and being drawn from wealthy homes confer an advantage on women to use modern maternal and child healthcare. Conclusion Pragmatic interventions should be initiated to encourage women’s enrolment in health insurance in Nigeria. Community-based health insurance scheme should be encouraged among rural women and those of them in the informal sector.

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Oluwasusi, JO, KA Thomas, MG Olujide, and YO Oluwasusi. "Utilization of midwives service scheme among women farmers in Southwestern Nigeria." Journal of Community Medicine and Health Solutions 1, no. 1 (December 7, 2020): 035–46. http://dx.doi.org/10.29328/journal.jcmhs.1001005.

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Maternal mortality accounts for most deaths in agrarian communities of Nigeria due to poor access to midwives services and inadequate Skilled Birth Attendants (SBAs). The Midwives Service Scheme (MSS) was established to engage more SBAs and advocate better utilization of pre and post-natal care services. Studies have focused on maternal mortality reduction, however, information on underlying factors that predispose MSS target beneficiaries to its utilization is scarce. Therefore, utilization of MSS among women farmers in southwestern Nigeria was investigated. A four-stage sampling procedure was used. Three states from southwestern states (Oyo, Ogun and Ekiti) were randomly selected. Thereafter, ten Local Government Areas (LGAs) from eighteen LGAs that adopted MSS programme in the selected states were sampled. Also, 30% of the MSS facilities in the sampled LGAs were selected, resulting in 13 MSS facilities. Proportionate sampling technique was used to select 20% of registered women farmers in the selected 13 MSS facilities to give 207 respondents. Interview schedule was used to collect data on respondents’ socioeconomic characteristics, Maternal Health Information Sources (MHIS), Maternal Health Information Seeking Behavior (MHISB) and utilization of MSS. Data were analyzed using descriptive and inferential statistics. About (55.6%) of the respondents had formal education. MHISB and effectiveness of MSS was rated low by 53.2% and 55.6% of the respondents, respectively. MSS was moderately utilized by 64.7% of the respondents. The MSS utilization was 49.24 ± 11.39 (Oyo), 45.08 ± 9.28 (Ogun) and 44.00 ± 10.71 (Ekiti). Respondents’ education (χ2 = 12.85), family size (r = 0.02), monthly income (r = 0.48) related positively and significantly (r = 0.27) to MSS utilization.

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Liyanto, Elvira, Dewi Nuryana, Restu Adya Cahyani, Budi Utomo, and Robert Magnani. "How well are Indonesia’s urban poor being provided access to quality reproductive health services?" PLOS ONE 17, no. 4 (April 12, 2022): e0265843. http://dx.doi.org/10.1371/journal.pone.0265843.

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Accommodating the needs of Indonesia’s rapidly growing urban population is essential to reaching national reproductive health goals and international commitments. As in other rapidly urbanizing low- and middle-income countries, satisfying the needs of Indonesia’s urban poor is both a high priority and a significant challenge. In this study, we assessed both how being from urban poor or near-poor households affects the quantity and quality of family planning and maternal health services received and the extent to which differentials had narrowed during the 2012–2017 period. This time interval is significant due to the introduction of a national social health insurance scheme in 2014, establishing the foundation for universal health care in the country. Data from the 2012 and 2017 Indonesian Demographic and Health Surveys were analyzed using logistic and multinomial logit regression. Poverty status was measured in terms of urban household wealth quintiles. For family planning, although urban poor and near-poor women made different method choices than non-poor women, no substantial 2017 differences in contraceptive prevalence, unmet need for family planning or informed choice were observed. However, urban poor women and to a lesser extent near-poor women systematically lagged non-poor urban women in both the quantity and quality of maternal health services received in connection with recent pregnancies. Significant maternal health service gains were observed for all urban women during the study reference period, with gains for poor and near poor urban women exceeding those for non-poor on several indicators. While the deployment of pro-poor interventions such as the national social health insurance scheme is likely to have contributed to these results, evidence suggesting that the scheme may not be influencing consumer health-seeking behaviors as had been anticipated along with continued limitations in public health sector supply-side readiness resulting in service quality issues suggest that more will have to be done.

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Purohit, Neetu, Vrinda Mehra, and Dipti Govil. "Tracking Benefits of Janani Suraksha Yojana—A Maternal Cash Transfer Scheme: Evidence from Rajasthan, India." Journal of Health Management 16, no. 2 (June 2014): 289–302. http://dx.doi.org/10.1177/0972063414526116.

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Gomes, Jéssica Rodrigues, Suélen Henriques Da Cruz, Andreas Bauer, Adriane Xavier Arteche, and Joseph Murray. "Maternal Communication with Preschool Children about Morality: A Coding Scheme for a Book-Sharing Task." International Journal of Environmental Research and Public Health 19, no. 18 (September 14, 2022): 11561. http://dx.doi.org/10.3390/ijerph191811561.

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Background: Preventing interpersonal violence requires understanding the moral development and determinants of child aggression. Communication about moral values and concerns by parents is theoretically important in this process. We aimed to develop a coding system to measure mothers’ communication about morality with young children and test its psychometric properties. Method: The cross-sectional study included a subsample (n = 200) of mothers and their four-year-old children in a population-based Brazilian birth cohort. Mothers and children were filmed while looking at a picture book together, containing events of aggression, taking away without asking, and several prosocial behaviours. Films were transcribed and a coding system, including 17 items, was developed to measure the maternal moral judgements and the explanations communicated to their children. Inter-rater reliability was estimated, and exploratory factor analysis performed. Results: Mothers judged acts of physical aggression as wrong more frequently than taking away material goods without asking; most mothers communicated about the emotional consequences of wrong behaviour with their child. Two latent factors of moral communication were identified, interpersonal moral concern and the expression of material moral concern. There was excellent inter-rater reliability between the two coders. Conclusions: Parent–child book-sharing provides a means to measure maternal communication about morality with their children. The coding system of this study measures both communication about interpersonal moral concern and material moral concern. Further studies with larger samples are suggested to investigate the importance of these dimensions of caregiver moral communication for children’s moral development.

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Ravit, Marion, Andrainolo Ravalihasy, Martine Audibert, Valéry Ridde, Emmanuel Bonnet, Bertille Raffalli, Flore-Apolline Roy, Anais N’Landu, and Alexandre Dumont. "The impact of the obstetrical risk insurance scheme in Mauritania on maternal healthcare utilization: a propensity score matching analysis." Health Policy and Planning 35, no. 4 (January 31, 2020): 388–98. http://dx.doi.org/10.1093/heapol/czz150.

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Abstract In Mauritania, obstetrical risk insurance (ORI) has been progressively implemented at the health district level since 2002 and was available in 25% of public healthcare facilities in 2015. The ORI scheme is based on pre-payment scheme principles and focuses on increasing the quality of and access to both maternal and perinatal healthcare. Compared with many community-based health insurance schemes, the ORI scheme is original because it is not based on risk pooling. For a pre-payment of 16–18 USD, women are covered during their pregnancy for antenatal care, skilled delivery, emergency obstetrical care [including caesarean section (C-section) and transfer] and a postnatal visit. The objective of this study is to evaluate the impact of ORI enrolment on maternal and child health services using data from the Multiple Indicator Cluster Survey (MICS) conducted in 2015. A total of 4172 women who delivered within the last 2 years before the interview were analysed. The effect of ORI enrolment on the outcomes was estimated using a propensity score matching estimation method. Fifty-eight per cent of the studied women were aware of ORI, and among these women, more than two-thirds were enrolled. ORI had a beneficial effect among the enrolled women by increasing the probability of having at least one prenatal visit by 13%, the probability of having four or more visits by 11% and the probability of giving birth at a healthcare facility by 15%. However, we found no effect on postnatal care (PNC), C-section rates or neonatal mortality. This study provides evidence that a voluntary pre-payment scheme focusing on pregnant women improves healthcare services utilization during pregnancy and delivery. However, no effect was found on PNC or neonatal mortality. Some efforts should be exerted to improve communication and accessibility to ORI.

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Justin Sossou, Adanmavokin, Gilles Armand Sossou, Alphonse Kpozehoue, Babatounde Charlemagne Igue, and Edgard-Marius Ouendo. "Willingness to Pay for Universal Health Coverage Scheme for Maternal and Child Health Care and Services in Benin." Central African Journal of Public Health 7, no. 3 (2021): 111. http://dx.doi.org/10.11648/j.cajph.20210703.14.

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Anafi, Patricia, Wisdom K. Mprah, Allen M. Jackson, Janelle J. Jacobson, Christopher M. Torres, Brent M. Crow, and Kathleen M. O’Rourke. "Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra." International Quarterly of Community Health Education 38, no. 4 (March 9, 2018): 259–67. http://dx.doi.org/10.1177/0272684x18763378.

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In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users’ perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

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Journal articles on the topic 'Maternal health voucher scheme'

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