Hostname: page-component-7c8c6479df-5xszh Total loading time: 0 Render date: 2024-03-29T13:54:51.681Z Has data issue: false hasContentIssue false

The Bangladesh Maternal Health Voucher Scheme: impact on completeness of antenatal care provision

Published online by Cambridge University Press:  25 January 2021

Mohammad Nahid Mia*
Affiliation:
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
Shehrin Shaila Mahmood
Affiliation:
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
Mohammad Iqbal
Affiliation:
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
Abbas Bhuiya
Affiliation:
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
Saseendran Pallikadavath
Affiliation:
Portsmouth-Brawijaya Centre for Global Health, Population, and Policy, University of Portsmouth, United Kingdom
William Stones
Affiliation:
Departments of Public Health and Obstetrics & Gynaecology, Malawi College of Medicine, Blantyre, Malawi
*
*Corresponding author. Email: nahid15sust@gmail.com

Abstract

This study aimed to assess completeness of antenatal care coverage following implementation of a voucher scheme for maternal health in Bangladesh. The investigation used interview data from a survey conducted in Bangladesh in 2017 of 2400 randomly selected women aged 15–49 with children aged 0–23 months in four geographical areas where voucher scheme implementation was underway. Of these women, 1944 had attended at least one antenatal clinic visit so were included in the analysis. A ‘completeness index’ for antenatal visits was constructed as an outcome variable based on recall of thirteen elements of care. Bivariate analysis against independent variables of interest was carried out and multivariate linear regression models developed to examine the influence of voucher scheme participation on completeness of antenatal care adjusting for socio-demographic characteristics. Voucher scheme membership was associated with higher ‘completeness index’ scores, with a mean score of 185.2±101.0 for voucher recipients and 139.6 ± 93.3 for non-recipients (p<0.001). Scheme membership reduced the differentials associated with health facility type and socioeconomic status. Women from the lowest socioeconomic group who were voucher recipients received substantially more components of antenatal care (mean score: 159.6±82.1) compared with non-recipients (mean score: 115.7±83.0). This favourable effect of voucher scheme membership on the most vulnerable socioeconomic group remained significant after adjusting for educational status. The Bangladesh voucher scheme model has the potential to maximize gains in maternal and newborn health through enhancing the completeness of service provision.

Type
Research Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahmed, S and Khan, MM (2010) A maternal health voucher scheme: what have we learned from the demand-side financing scheme in Bangladesh? Health Policy and Planning 26(1), 2532.Google ScholarPubMed
Ahmed, S and Khan, MM (2011) Is demand-side financing equity enhancing? Lessons from a maternal health voucher scheme in Bangladesh. Social Science & Medicine 72(10), 17041710.CrossRefGoogle ScholarPubMed
Anwar, I, Blaakman, A and Akhter, S (2013) Program Evaluation for Demand Side Financing Maternal Health Voucher Scheme in Bangladesh: Final Report. HERA, Reet, Dhaka, Bangladesh.Google Scholar
Anwar, I, Sami, M, Akhtar, N, Chowdhury, M, Salma, U, Rahman, M et al. (2008) Inequity in maternal health-care services: evidence from home-based skilled-birth-attendant programmes in Bangladesh. Bulletin of the World Health Organization 86, 252259.CrossRefGoogle ScholarPubMed
Bangladesh Planning Commission (2013) Millennium Development Goals: Bangladesh Progress Report 2015. Bangladesh Planning Commission, Dhaka, Bangladesh.Google Scholar
Bhatia, M and Gorter, A (2007) Improving access to reproductive and child health services in developing countries: are competitive voucher schemes an option? Journal of International Development 19(7), 975981.CrossRefGoogle Scholar
Bhatia, M, Yesudian, C, Gorter, A and Thankappan, K (2006) Demand side financing for reproductive and child health services in India. Economic and Political Weekly 41(3), 279284.Google Scholar
Filmer, D and Pritchett, LH (2001) Estimating wealth effects without expenditure data—or tears: an application to educational enrolments in states of India. Demography 38(1), 115132.Google Scholar
Heredia, PI, Servan, ME, Darney, BG, Reyes, M and Lozano, RH (2016) Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico. Bulletin of the World Health Organization 94(6), 452.CrossRefGoogle Scholar
Hulton, L, Matthews, Z and Stones, RW (2000) A Framework for the Evaluation of Quality of Care in Maternity services. URL: https://eprints.soton.ac.uk/40965/1/12757_Matthews.pdf (accessed 16th June 2019).Google Scholar
Lim, SS, Dandona, L, Hoisington, JA, James, SL, Hogan, MC and Gakidou, E (2010) India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation. The Lancet 375(9730), 20092023.CrossRefGoogle ScholarPubMed
Mahmood, SS, Amos, M, Hoque, S, Mia, MN, Chowdhury, AH, Hanifi, SM et al. (2019). Does healthcare voucher provision improve utilisation in the continuum of maternal care for poor pregnant women? Experience from Bangladesh. Global Health Action 12(1), 1701324.CrossRefGoogle ScholarPubMed
Målqvist, M, Yuan, B, Trygg, N, Selling, K and Thomsen, S (2013) Targeted interventions for improved equity in maternal and child health in low-and middle-income settings: a systematic review and meta-analysis. PLoS One 8(6), 66453.CrossRefGoogle ScholarPubMed
MMEIAG (2015) Maternal Mortality in 1990–2015. Maternal Mortality Estimation Inter-Agency Group, URL: https://data.worldbank.org/indicator/SH.STA.MMRT?locations=BD (accessed 1st June 2019).Google Scholar
Menotti, EP and Farrell, M (2016) Vouchers: a hot ticket for reaching the poor and other special groups with voluntary family planning services. Global Health: Science and Practice 4(3), 384393.Google ScholarPubMed
Murray, SF, Hunter, BM, Bisht, R, Ensor, T and Bick, D (2014) Effects of demand-side financing on utilisation, experiences and outcomes of maternity care in low-and middle-income countries: a systematic review. BMC Pregnancy and Childbirth 14(1), 30.CrossRefGoogle ScholarPubMed
NIPORT, Mitra and Associates, ICF International and ICBBR,B (2012) Bangladesh Maternal Mortality and Health Care Survey 2010. National Institute of Population Research and Training (NIPORT) and ICF International, Dhaka, Bangladesh; MEASURE Evaluation and ICDDR,B, Dhaka, Bangladesh,Google Scholar
NIPORT, Mitra and Associates and ICF International (2016) Bangladesh Demographic and Health Survey 2014. Bangladesh National Institute of Population Research and Training (NIPORT) and ICF International, Dhaka, Bangladesh.Google Scholar
Talukder, MN, Rob, U, Musa, S, Bajracharya, A, Keya, KT, Noor, FR et al. (2014) Evaluation of the impact of the voucher program for improving maternal health behavior and status in Bangladesh. Population Council, doi 10.31899/rh10.1000.Google Scholar
Tunçalp, Ö, Were, W, Maclennan, C, Oladapo, O, Gülmezoglu, A, Bahl, R et al. (2015) Quality of care for pregnant women and newborn – the WHO vision. BJOG: An International Journal of Obstetrics & Gynaecology 122(8), 10451049.CrossRefGoogle ScholarPubMed