Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia
Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia
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DOI：
10.1016/s0968-8080(12)39609-2
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发表时间：
2012-05-01
影响因子：
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通讯作者：
de Costa, Ayesha
中科院分区：
文献类型：
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作者：
Jehan, Kate;Sidney, Kristi;de Costa, Ayesha
在尼泊尔、印度、孟加拉国和巴基斯坦，侧重于改善孕产妇服务的政策已导致采取措施，减少阻碍妇女获得护理的费用障碍。具体而言，这些措施包括旨在刺激服务需求的现金转移或代金券计划，包括产前、分娩和产后护理。然而，尽管这些计划很受欢迎，但人们对这些计划的影响或有效性知之甚少。本文件概述了五项主要干预措施：尼泊尔的Aama（母亲）方案（现金转移部分）;印度的Janani Suraksha Yojana（安全孕产计划）;印度的Chiranjeevi Yojana（长寿计划）;孟加拉国的产妇保健计划和巴基斯坦的Sehat（保健）计划。它根据现有数据审查了每项计划的目标、理由、执行挑战、已知成果、潜力和局限性。据报告，自这些计划开始以来，孕产妇保健服务的使用有所增加，但由于缺乏对照研究，尚未确定孕产妇保健成果改善的证据。本次审查确定了这些计划需要改进的领域，包括需要更有效的业务管理、明确的准则、财务透明度、可持续性计划、公平的证据，以及最重要的是对护理质量和孕产妇死亡率和发病率的实际影响。(C)2012年生殖健康事项
In Nepal, India, Bangladesh and Pakistan, policy focused on improving access to maternity services has led to measures to reduce cost barriers impeding women's access to care. Specifically, these include cash transfer or voucher schemes designed to stimulate demand for services, including antenatal, delivery and post-partum care. In spite of their popularity, however, little is known about the impact or effectiveness of these schemes. This paper provides an overview of five major interventions: the Aama (Mothers') Programme (cash transfer element) in Nepal; the Janani Suraksha Yojana (Safe Motherhood Scheme) in India; the Chiranjeevi Yojana (Scheme for Long Life) in India; the Maternal Health Voucher Scheme in Bangladesh and the Sehat (Health) Voucher Scheme in Pakistan. It reviews the aims, rationale, implementation challenges, known outcomes, potential and limitations of each scheme based on current available data. Increased use of maternal health services has been reported since the schemes began, though evidence of improvements in maternal health outcomes has not been established due to a lack of controlled studies. Areas for improvement in these schemes, identified in this review, include the need for more efficient operational management, clear guidelines, financial transparency, plans for sustainability, evidence of equity and, above all, proven impact on quality of care and maternal mortality and morbidity. (C) 2012 Reproductive Health Matters