Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme

Vouchers stimulate demand for health care services by giving beneficiaries purchasing power. In turn, health facilities’ claims are reimbursed for providing beneficiaries with improved quality of health care. Efficient strategies to generate demand from new, often poor, users and supply in the form of increased access and expanded scope of services would help move Uganda away from inequity and toward universal health care. A reproductive health voucher program was implemented in 20 western and southwest Ugandan districts from April 2008 to March 2012. Using three years of data, this impact evaluation study employed a quasi-experimental design to examine differences in utilization of health services among women in voucher and nonvoucher villages. Two key findings were a 16-percentage-point net increase in private facility deliveries and a decrease in home deliveries among women who had used the voucher, indicating the project likely made contributions to increase private facility births in villages with voucher clients. No statistically significant difference was seen between respondents from voucher and nonvoucher villages in the use of postnatal care services, or in attending four or more antenatal care visits. A net 33-percentage-point decrease in out-of-pocket expenditure at private facilities in villages with voucher clients was found, and a higher percentage of voucher users came from households in the two poorest quintiles. The greater uptake of facility births by respondents in voucher villages compared with controls indicates that the approach has the potential to accelerate service uptake. A scaled program could help to move the country toward universal coverage of maternal health care.

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Bibliographic Details
Main Authors: Obare, Francis, Okwero, Peter, Villegas, Leslie, Mills, Samuel, Bellows, Ben
Format: Working Paper biblioteca
Language:English
en_US
Published: World Bank, Washington, DC 2016-06
Subjects:POPULATION STRATEGY, CHILD HEALTH, RISKS, ADOLESCENT REPRODUCTIVE HEALTH, REPRODUCTIVE HEALTH, NORMAL DELIVERIES, SEX WORKERS, LOCAL POPULATION, QUALITY OF SERVICES, MATERNAL MORBIDITY, CONTRACEPTION, INFORMED CONSENT, SKILLED HEALTH PERSONNEL, EMPOWERMENT OF WOMEN, FAMILY PLANNING PROGRAM, ANTENATAL CARE, QUALITY OF HEALTH CARE, LOW-INCOME POPULATIONS, LIVE BIRTHS, MORBIDITY, SEXUALLY TRANSMITTED DISEASES, REDUCING MATERNAL MORTALITY, DEVELOPING COUNTRIES, PUBLIC SERVICES, HOME DELIVERIES, HEALTH CARE, DRUGS, ACQUIRED IMMUNODEFICIENCY SYNDROME, NATIONAL FAMILY PLANNING, SEXUALLY TRANSMITTED INFECTIONS, HEALTH, POLICY DISCUSSIONS, REPRODUCTIVE HEALTH INDICATORS, PROVISION OF SERVICES, DELIVERY COSTS, HYPERTENSION, IMPROVING HEALTH CARE, FAMILY PLANNING PROGRAMS, HEALTH FACILITIES, HOSPITAL, PUBLIC HEALTH, LIFE EXPECTANCY, MATERNAL MORTALITY, INEQUITIES, HEALTH SECTOR, KNOWLEDGE, PHARMACIES, MINISTRY OF HEALTH, DISEASES, MILLENNIUM DEVELOPMENT GOAL, PREGNANCIES, TRAINING, STERILIZATION, PATIENT, INTERVENTION, SEXUAL PARTNER, HEALTH INDICATORS, HEALTH SYSTEMS, REPRODUCTIVE HEALTH CARE, REFERRAL FACILITY, NATIONAL FAMILY PLANNING PROGRAMS, NURSES, STIS, HEALTH CARE SERVICES, OBSERVATION, VIOLENCE, ACCESS TO HEALTH SERVICES, MARKETING, REPRODUCTIVE HEALTH COMMODITIES, SERVICE PROVIDER, SAFE MOTHERHOOD, HOUSEHOLD SURVEYS, SERVICE PROVISION, MATERNAL HEALTH OUTCOMES, COMMERCIAL SEX WORKERS, SERVICE DELIVERY, HEALTH-SECTOR, INTERVIEW, HOUSEHOLD ASSETS, MATERNAL HEALTH CARE, MORTALITY, RADIO, RISK GROUPS, RESPECT, PROGRESS, SKILLED ATTENDANT, CHILDBIRTH, DISEASE SYMPTOMS, PREGNANCY COMPLICATIONS, FOOD SECURITY, WORKERS, QUALITY OF CARE, CAESAREAN SECTION, LOW-INCOME COUNTRY, HIV, MATERNAL HEALTH SERVICES, POSTNATAL CARE, IMMUNODEFICIENCY, WOMAN, POLICY RESEARCH WORKING PAPER, POOR MATERNAL HEALTH, POLICY MAKERS, HEALTH POLICY, PURCHASING POWER, HEALTH OUTCOMES, IMPROVEMENTS IN QUALITY OF CARE, FAMILY PLANNING, SOCIAL SCIENCE, POPULATION COUNCIL, MEASUREMENT, USE OF MATERNAL HEALTH SERVICES, NUTRITION, SERVICE UTILIZATION, SERVICE QUALITY, POPULATIONS, INJURIES, QUALITY SERVICES, MALARIA, ADOLESCENTS, BULLETIN, CHILDBEARING, POLICY, WORLD HEALTH ORGANIZATION, CHILD MORTALITY, MATERNAL MORTALITY RATIO, HEALTH SYSTEM, FEMALE STERILIZATION, BABIES, DELIVERY CARE, SEX, WEIGHT, PREGNANT WOMEN, MATERNAL HEALTH, REPRODUCTIVE HEALTH SERVICES, COMMERCIAL SEX, CHILDREN, LEVEL OF EDUCATION, MORTALITY RATIO, MATERNAL DEATHS, HEALTH PROBLEMS, MIDWIVES, RURAL AREAS, NUMBER OF CHILDREN, ACCESS TO FAMILY PLANNING, SOCIAL COHESION, POPULATION, MARITAL STATUS, NEONATAL MORTALITY, POLICY RESEARCH, STRATEGY, FERTILITY, CHILD HEALTH SERVICES, WOMEN, EMERGENCY OBSTETRIC CARE, NEWBORN, FAMILY PLANNING SERVICES, EMERGENCY CARE, ADOLESCENT HEALTH, POLICY ANALYSIS, OBSTETRIC CARE, AIDS, COMPLICATIONS, HEALTH SERVICES, IMPLEMENTATION, PREGNANCY, ABORTION, NEWBORN CARE, C-SECTION, GENDER EQUALITY, NURSING, NATIONAL HEALTH SYSTEMS, SERVICE PROVIDERS, DEVELOPMENT POLICY, HUMAN DEVELOPMENT,
Online Access:http://documents.worldbank.org/curated/en/2016/06/26506638/increased-coverage-maternal-health-services-among-poor-western-uganda-output-based-aid-voucher-scheme
https://hdl.handle.net/10986/24626
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libraryname Biblioteca del Banco Mundial
language English
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topic POPULATION STRATEGY
CHILD HEALTH
RISKS
ADOLESCENT REPRODUCTIVE HEALTH
REPRODUCTIVE HEALTH
NORMAL DELIVERIES
SEX WORKERS
LOCAL POPULATION
QUALITY OF SERVICES
MATERNAL MORBIDITY
CONTRACEPTION
INFORMED CONSENT
SKILLED HEALTH PERSONNEL
EMPOWERMENT OF WOMEN
FAMILY PLANNING PROGRAM
ANTENATAL CARE
QUALITY OF HEALTH CARE
LOW-INCOME POPULATIONS
LIVE BIRTHS
MORBIDITY
SEXUALLY TRANSMITTED DISEASES
REDUCING MATERNAL MORTALITY
DEVELOPING COUNTRIES
PUBLIC SERVICES
HOME DELIVERIES
HEALTH CARE
DRUGS
ACQUIRED IMMUNODEFICIENCY SYNDROME
NATIONAL FAMILY PLANNING
SEXUALLY TRANSMITTED INFECTIONS
HEALTH
POLICY DISCUSSIONS
REPRODUCTIVE HEALTH INDICATORS
PROVISION OF SERVICES
DELIVERY COSTS
HYPERTENSION
IMPROVING HEALTH CARE
FAMILY PLANNING PROGRAMS
HEALTH FACILITIES
HOSPITAL
PUBLIC HEALTH
LIFE EXPECTANCY
MATERNAL MORTALITY
INEQUITIES
HEALTH SECTOR
KNOWLEDGE
PHARMACIES
MINISTRY OF HEALTH
DISEASES
MILLENNIUM DEVELOPMENT GOAL
PREGNANCIES
TRAINING
STERILIZATION
PATIENT
INTERVENTION
SEXUAL PARTNER
HEALTH INDICATORS
HEALTH SYSTEMS
REPRODUCTIVE HEALTH CARE
REFERRAL FACILITY
NATIONAL FAMILY PLANNING PROGRAMS
NURSES
STIS
HEALTH CARE SERVICES
OBSERVATION
VIOLENCE
ACCESS TO HEALTH SERVICES
MARKETING
REPRODUCTIVE HEALTH COMMODITIES
SERVICE PROVIDER
SAFE MOTHERHOOD
HOUSEHOLD SURVEYS
SERVICE PROVISION
MATERNAL HEALTH OUTCOMES
COMMERCIAL SEX WORKERS
SERVICE DELIVERY
HEALTH-SECTOR
INTERVIEW
HOUSEHOLD ASSETS
MATERNAL HEALTH CARE
MORTALITY
RADIO
RISK GROUPS
RESPECT
PROGRESS
SKILLED ATTENDANT
CHILDBIRTH
DISEASE SYMPTOMS
PREGNANCY COMPLICATIONS
FOOD SECURITY
WORKERS
QUALITY OF CARE
CAESAREAN SECTION
LOW-INCOME COUNTRY
HIV
MATERNAL HEALTH SERVICES
POSTNATAL CARE
IMMUNODEFICIENCY
WOMAN
POLICY RESEARCH WORKING PAPER
POOR MATERNAL HEALTH
POLICY MAKERS
HEALTH POLICY
PURCHASING POWER
HEALTH OUTCOMES
IMPROVEMENTS IN QUALITY OF CARE
FAMILY PLANNING
SOCIAL SCIENCE
POPULATION COUNCIL
MEASUREMENT
USE OF MATERNAL HEALTH SERVICES
NUTRITION
SERVICE UTILIZATION
SERVICE QUALITY
POPULATIONS
INJURIES
QUALITY SERVICES
MALARIA
ADOLESCENTS
BULLETIN
CHILDBEARING
POLICY
WORLD HEALTH ORGANIZATION
CHILD MORTALITY
MATERNAL MORTALITY RATIO
HEALTH SYSTEM
FEMALE STERILIZATION
BABIES
DELIVERY CARE
SEX
WEIGHT
PREGNANT WOMEN
MATERNAL HEALTH
REPRODUCTIVE HEALTH SERVICES
COMMERCIAL SEX
CHILDREN
LEVEL OF EDUCATION
MORTALITY RATIO
MATERNAL DEATHS
HEALTH PROBLEMS
MIDWIVES
RURAL AREAS
NUMBER OF CHILDREN
ACCESS TO FAMILY PLANNING
SOCIAL COHESION
POPULATION
MARITAL STATUS
NEONATAL MORTALITY
POLICY RESEARCH
STRATEGY
FERTILITY
CHILD HEALTH SERVICES
WOMEN
EMERGENCY OBSTETRIC CARE
NEWBORN
FAMILY PLANNING SERVICES
EMERGENCY CARE
ADOLESCENT HEALTH
POLICY ANALYSIS
OBSTETRIC CARE
AIDS
COMPLICATIONS
HEALTH SERVICES
IMPLEMENTATION
PREGNANCY
ABORTION
NEWBORN CARE
C-SECTION
GENDER EQUALITY
NURSING
NATIONAL HEALTH SYSTEMS
SERVICE PROVIDERS
DEVELOPMENT POLICY
HUMAN DEVELOPMENT
POPULATION STRATEGY
CHILD HEALTH
RISKS
ADOLESCENT REPRODUCTIVE HEALTH
REPRODUCTIVE HEALTH
NORMAL DELIVERIES
SEX WORKERS
LOCAL POPULATION
QUALITY OF SERVICES
MATERNAL MORBIDITY
CONTRACEPTION
INFORMED CONSENT
SKILLED HEALTH PERSONNEL
EMPOWERMENT OF WOMEN
FAMILY PLANNING PROGRAM
ANTENATAL CARE
QUALITY OF HEALTH CARE
LOW-INCOME POPULATIONS
LIVE BIRTHS
MORBIDITY
SEXUALLY TRANSMITTED DISEASES
REDUCING MATERNAL MORTALITY
DEVELOPING COUNTRIES
PUBLIC SERVICES
HOME DELIVERIES
HEALTH CARE
DRUGS
ACQUIRED IMMUNODEFICIENCY SYNDROME
NATIONAL FAMILY PLANNING
SEXUALLY TRANSMITTED INFECTIONS
HEALTH
POLICY DISCUSSIONS
REPRODUCTIVE HEALTH INDICATORS
PROVISION OF SERVICES
DELIVERY COSTS
HYPERTENSION
IMPROVING HEALTH CARE
FAMILY PLANNING PROGRAMS
HEALTH FACILITIES
HOSPITAL
PUBLIC HEALTH
LIFE EXPECTANCY
MATERNAL MORTALITY
INEQUITIES
HEALTH SECTOR
KNOWLEDGE
PHARMACIES
MINISTRY OF HEALTH
DISEASES
MILLENNIUM DEVELOPMENT GOAL
PREGNANCIES
TRAINING
STERILIZATION
PATIENT
INTERVENTION
SEXUAL PARTNER
HEALTH INDICATORS
HEALTH SYSTEMS
REPRODUCTIVE HEALTH CARE
REFERRAL FACILITY
NATIONAL FAMILY PLANNING PROGRAMS
NURSES
STIS
HEALTH CARE SERVICES
OBSERVATION
VIOLENCE
ACCESS TO HEALTH SERVICES
MARKETING
REPRODUCTIVE HEALTH COMMODITIES
SERVICE PROVIDER
SAFE MOTHERHOOD
HOUSEHOLD SURVEYS
SERVICE PROVISION
MATERNAL HEALTH OUTCOMES
COMMERCIAL SEX WORKERS
SERVICE DELIVERY
HEALTH-SECTOR
INTERVIEW
HOUSEHOLD ASSETS
MATERNAL HEALTH CARE
MORTALITY
RADIO
RISK GROUPS
RESPECT
PROGRESS
SKILLED ATTENDANT
CHILDBIRTH
DISEASE SYMPTOMS
PREGNANCY COMPLICATIONS
FOOD SECURITY
WORKERS
QUALITY OF CARE
CAESAREAN SECTION
LOW-INCOME COUNTRY
HIV
MATERNAL HEALTH SERVICES
POSTNATAL CARE
IMMUNODEFICIENCY
WOMAN
POLICY RESEARCH WORKING PAPER
POOR MATERNAL HEALTH
POLICY MAKERS
HEALTH POLICY
PURCHASING POWER
HEALTH OUTCOMES
IMPROVEMENTS IN QUALITY OF CARE
FAMILY PLANNING
SOCIAL SCIENCE
POPULATION COUNCIL
MEASUREMENT
USE OF MATERNAL HEALTH SERVICES
NUTRITION
SERVICE UTILIZATION
SERVICE QUALITY
POPULATIONS
INJURIES
QUALITY SERVICES
MALARIA
ADOLESCENTS
BULLETIN
CHILDBEARING
POLICY
WORLD HEALTH ORGANIZATION
CHILD MORTALITY
MATERNAL MORTALITY RATIO
HEALTH SYSTEM
FEMALE STERILIZATION
BABIES
DELIVERY CARE
SEX
WEIGHT
PREGNANT WOMEN
MATERNAL HEALTH
REPRODUCTIVE HEALTH SERVICES
COMMERCIAL SEX
CHILDREN
LEVEL OF EDUCATION
MORTALITY RATIO
MATERNAL DEATHS
HEALTH PROBLEMS
MIDWIVES
RURAL AREAS
NUMBER OF CHILDREN
ACCESS TO FAMILY PLANNING
SOCIAL COHESION
POPULATION
MARITAL STATUS
NEONATAL MORTALITY
POLICY RESEARCH
STRATEGY
FERTILITY
CHILD HEALTH SERVICES
WOMEN
EMERGENCY OBSTETRIC CARE
NEWBORN
FAMILY PLANNING SERVICES
EMERGENCY CARE
ADOLESCENT HEALTH
POLICY ANALYSIS
OBSTETRIC CARE
AIDS
COMPLICATIONS
HEALTH SERVICES
IMPLEMENTATION
PREGNANCY
ABORTION
NEWBORN CARE
C-SECTION
GENDER EQUALITY
NURSING
NATIONAL HEALTH SYSTEMS
SERVICE PROVIDERS
DEVELOPMENT POLICY
HUMAN DEVELOPMENT
spellingShingle POPULATION STRATEGY
CHILD HEALTH
RISKS
ADOLESCENT REPRODUCTIVE HEALTH
REPRODUCTIVE HEALTH
NORMAL DELIVERIES
SEX WORKERS
LOCAL POPULATION
QUALITY OF SERVICES
MATERNAL MORBIDITY
CONTRACEPTION
INFORMED CONSENT
SKILLED HEALTH PERSONNEL
EMPOWERMENT OF WOMEN
FAMILY PLANNING PROGRAM
ANTENATAL CARE
QUALITY OF HEALTH CARE
LOW-INCOME POPULATIONS
LIVE BIRTHS
MORBIDITY
SEXUALLY TRANSMITTED DISEASES
REDUCING MATERNAL MORTALITY
DEVELOPING COUNTRIES
PUBLIC SERVICES
HOME DELIVERIES
HEALTH CARE
DRUGS
ACQUIRED IMMUNODEFICIENCY SYNDROME
NATIONAL FAMILY PLANNING
SEXUALLY TRANSMITTED INFECTIONS
HEALTH
POLICY DISCUSSIONS
REPRODUCTIVE HEALTH INDICATORS
PROVISION OF SERVICES
DELIVERY COSTS
HYPERTENSION
IMPROVING HEALTH CARE
FAMILY PLANNING PROGRAMS
HEALTH FACILITIES
HOSPITAL
PUBLIC HEALTH
LIFE EXPECTANCY
MATERNAL MORTALITY
INEQUITIES
HEALTH SECTOR
KNOWLEDGE
PHARMACIES
MINISTRY OF HEALTH
DISEASES
MILLENNIUM DEVELOPMENT GOAL
PREGNANCIES
TRAINING
STERILIZATION
PATIENT
INTERVENTION
SEXUAL PARTNER
HEALTH INDICATORS
HEALTH SYSTEMS
REPRODUCTIVE HEALTH CARE
REFERRAL FACILITY
NATIONAL FAMILY PLANNING PROGRAMS
NURSES
STIS
HEALTH CARE SERVICES
OBSERVATION
VIOLENCE
ACCESS TO HEALTH SERVICES
MARKETING
REPRODUCTIVE HEALTH COMMODITIES
SERVICE PROVIDER
SAFE MOTHERHOOD
HOUSEHOLD SURVEYS
SERVICE PROVISION
MATERNAL HEALTH OUTCOMES
COMMERCIAL SEX WORKERS
SERVICE DELIVERY
HEALTH-SECTOR
INTERVIEW
HOUSEHOLD ASSETS
MATERNAL HEALTH CARE
MORTALITY
RADIO
RISK GROUPS
RESPECT
PROGRESS
SKILLED ATTENDANT
CHILDBIRTH
DISEASE SYMPTOMS
PREGNANCY COMPLICATIONS
FOOD SECURITY
WORKERS
QUALITY OF CARE
CAESAREAN SECTION
LOW-INCOME COUNTRY
HIV
MATERNAL HEALTH SERVICES
POSTNATAL CARE
IMMUNODEFICIENCY
WOMAN
POLICY RESEARCH WORKING PAPER
POOR MATERNAL HEALTH
POLICY MAKERS
HEALTH POLICY
PURCHASING POWER
HEALTH OUTCOMES
IMPROVEMENTS IN QUALITY OF CARE
FAMILY PLANNING
SOCIAL SCIENCE
POPULATION COUNCIL
MEASUREMENT
USE OF MATERNAL HEALTH SERVICES
NUTRITION
SERVICE UTILIZATION
SERVICE QUALITY
POPULATIONS
INJURIES
QUALITY SERVICES
MALARIA
ADOLESCENTS
BULLETIN
CHILDBEARING
POLICY
WORLD HEALTH ORGANIZATION
CHILD MORTALITY
MATERNAL MORTALITY RATIO
HEALTH SYSTEM
FEMALE STERILIZATION
BABIES
DELIVERY CARE
SEX
WEIGHT
PREGNANT WOMEN
MATERNAL HEALTH
REPRODUCTIVE HEALTH SERVICES
COMMERCIAL SEX
CHILDREN
LEVEL OF EDUCATION
MORTALITY RATIO
MATERNAL DEATHS
HEALTH PROBLEMS
MIDWIVES
RURAL AREAS
NUMBER OF CHILDREN
ACCESS TO FAMILY PLANNING
SOCIAL COHESION
POPULATION
MARITAL STATUS
NEONATAL MORTALITY
POLICY RESEARCH
STRATEGY
FERTILITY
CHILD HEALTH SERVICES
WOMEN
EMERGENCY OBSTETRIC CARE
NEWBORN
FAMILY PLANNING SERVICES
EMERGENCY CARE
ADOLESCENT HEALTH
POLICY ANALYSIS
OBSTETRIC CARE
AIDS
COMPLICATIONS
HEALTH SERVICES
IMPLEMENTATION
PREGNANCY
ABORTION
NEWBORN CARE
C-SECTION
GENDER EQUALITY
NURSING
NATIONAL HEALTH SYSTEMS
SERVICE PROVIDERS
DEVELOPMENT POLICY
HUMAN DEVELOPMENT
POPULATION STRATEGY
CHILD HEALTH
RISKS
ADOLESCENT REPRODUCTIVE HEALTH
REPRODUCTIVE HEALTH
NORMAL DELIVERIES
SEX WORKERS
LOCAL POPULATION
QUALITY OF SERVICES
MATERNAL MORBIDITY
CONTRACEPTION
INFORMED CONSENT
SKILLED HEALTH PERSONNEL
EMPOWERMENT OF WOMEN
FAMILY PLANNING PROGRAM
ANTENATAL CARE
QUALITY OF HEALTH CARE
LOW-INCOME POPULATIONS
LIVE BIRTHS
MORBIDITY
SEXUALLY TRANSMITTED DISEASES
REDUCING MATERNAL MORTALITY
DEVELOPING COUNTRIES
PUBLIC SERVICES
HOME DELIVERIES
HEALTH CARE
DRUGS
ACQUIRED IMMUNODEFICIENCY SYNDROME
NATIONAL FAMILY PLANNING
SEXUALLY TRANSMITTED INFECTIONS
HEALTH
POLICY DISCUSSIONS
REPRODUCTIVE HEALTH INDICATORS
PROVISION OF SERVICES
DELIVERY COSTS
HYPERTENSION
IMPROVING HEALTH CARE
FAMILY PLANNING PROGRAMS
HEALTH FACILITIES
HOSPITAL
PUBLIC HEALTH
LIFE EXPECTANCY
MATERNAL MORTALITY
INEQUITIES
HEALTH SECTOR
KNOWLEDGE
PHARMACIES
MINISTRY OF HEALTH
DISEASES
MILLENNIUM DEVELOPMENT GOAL
PREGNANCIES
TRAINING
STERILIZATION
PATIENT
INTERVENTION
SEXUAL PARTNER
HEALTH INDICATORS
HEALTH SYSTEMS
REPRODUCTIVE HEALTH CARE
REFERRAL FACILITY
NATIONAL FAMILY PLANNING PROGRAMS
NURSES
STIS
HEALTH CARE SERVICES
OBSERVATION
VIOLENCE
ACCESS TO HEALTH SERVICES
MARKETING
REPRODUCTIVE HEALTH COMMODITIES
SERVICE PROVIDER
SAFE MOTHERHOOD
HOUSEHOLD SURVEYS
SERVICE PROVISION
MATERNAL HEALTH OUTCOMES
COMMERCIAL SEX WORKERS
SERVICE DELIVERY
HEALTH-SECTOR
INTERVIEW
HOUSEHOLD ASSETS
MATERNAL HEALTH CARE
MORTALITY
RADIO
RISK GROUPS
RESPECT
PROGRESS
SKILLED ATTENDANT
CHILDBIRTH
DISEASE SYMPTOMS
PREGNANCY COMPLICATIONS
FOOD SECURITY
WORKERS
QUALITY OF CARE
CAESAREAN SECTION
LOW-INCOME COUNTRY
HIV
MATERNAL HEALTH SERVICES
POSTNATAL CARE
IMMUNODEFICIENCY
WOMAN
POLICY RESEARCH WORKING PAPER
POOR MATERNAL HEALTH
POLICY MAKERS
HEALTH POLICY
PURCHASING POWER
HEALTH OUTCOMES
IMPROVEMENTS IN QUALITY OF CARE
FAMILY PLANNING
SOCIAL SCIENCE
POPULATION COUNCIL
MEASUREMENT
USE OF MATERNAL HEALTH SERVICES
NUTRITION
SERVICE UTILIZATION
SERVICE QUALITY
POPULATIONS
INJURIES
QUALITY SERVICES
MALARIA
ADOLESCENTS
BULLETIN
CHILDBEARING
POLICY
WORLD HEALTH ORGANIZATION
CHILD MORTALITY
MATERNAL MORTALITY RATIO
HEALTH SYSTEM
FEMALE STERILIZATION
BABIES
DELIVERY CARE
SEX
WEIGHT
PREGNANT WOMEN
MATERNAL HEALTH
REPRODUCTIVE HEALTH SERVICES
COMMERCIAL SEX
CHILDREN
LEVEL OF EDUCATION
MORTALITY RATIO
MATERNAL DEATHS
HEALTH PROBLEMS
MIDWIVES
RURAL AREAS
NUMBER OF CHILDREN
ACCESS TO FAMILY PLANNING
SOCIAL COHESION
POPULATION
MARITAL STATUS
NEONATAL MORTALITY
POLICY RESEARCH
STRATEGY
FERTILITY
CHILD HEALTH SERVICES
WOMEN
EMERGENCY OBSTETRIC CARE
NEWBORN
FAMILY PLANNING SERVICES
EMERGENCY CARE
ADOLESCENT HEALTH
POLICY ANALYSIS
OBSTETRIC CARE
AIDS
COMPLICATIONS
HEALTH SERVICES
IMPLEMENTATION
PREGNANCY
ABORTION
NEWBORN CARE
C-SECTION
GENDER EQUALITY
NURSING
NATIONAL HEALTH SYSTEMS
SERVICE PROVIDERS
DEVELOPMENT POLICY
HUMAN DEVELOPMENT
Obare, Francis
Okwero, Peter
Villegas, Leslie
Mills, Samuel
Bellows, Ben
Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme
description Vouchers stimulate demand for health care services by giving beneficiaries purchasing power. In turn, health facilities’ claims are reimbursed for providing beneficiaries with improved quality of health care. Efficient strategies to generate demand from new, often poor, users and supply in the form of increased access and expanded scope of services would help move Uganda away from inequity and toward universal health care. A reproductive health voucher program was implemented in 20 western and southwest Ugandan districts from April 2008 to March 2012. Using three years of data, this impact evaluation study employed a quasi-experimental design to examine differences in utilization of health services among women in voucher and nonvoucher villages. Two key findings were a 16-percentage-point net increase in private facility deliveries and a decrease in home deliveries among women who had used the voucher, indicating the project likely made contributions to increase private facility births in villages with voucher clients. No statistically significant difference was seen between respondents from voucher and nonvoucher villages in the use of postnatal care services, or in attending four or more antenatal care visits. A net 33-percentage-point decrease in out-of-pocket expenditure at private facilities in villages with voucher clients was found, and a higher percentage of voucher users came from households in the two poorest quintiles. The greater uptake of facility births by respondents in voucher villages compared with controls indicates that the approach has the potential to accelerate service uptake. A scaled program could help to move the country toward universal coverage of maternal health care.
format Working Paper
topic_facet POPULATION STRATEGY
CHILD HEALTH
RISKS
ADOLESCENT REPRODUCTIVE HEALTH
REPRODUCTIVE HEALTH
NORMAL DELIVERIES
SEX WORKERS
LOCAL POPULATION
QUALITY OF SERVICES
MATERNAL MORBIDITY
CONTRACEPTION
INFORMED CONSENT
SKILLED HEALTH PERSONNEL
EMPOWERMENT OF WOMEN
FAMILY PLANNING PROGRAM
ANTENATAL CARE
QUALITY OF HEALTH CARE
LOW-INCOME POPULATIONS
LIVE BIRTHS
MORBIDITY
SEXUALLY TRANSMITTED DISEASES
REDUCING MATERNAL MORTALITY
DEVELOPING COUNTRIES
PUBLIC SERVICES
HOME DELIVERIES
HEALTH CARE
DRUGS
ACQUIRED IMMUNODEFICIENCY SYNDROME
NATIONAL FAMILY PLANNING
SEXUALLY TRANSMITTED INFECTIONS
HEALTH
POLICY DISCUSSIONS
REPRODUCTIVE HEALTH INDICATORS
PROVISION OF SERVICES
DELIVERY COSTS
HYPERTENSION
IMPROVING HEALTH CARE
FAMILY PLANNING PROGRAMS
HEALTH FACILITIES
HOSPITAL
PUBLIC HEALTH
LIFE EXPECTANCY
MATERNAL MORTALITY
INEQUITIES
HEALTH SECTOR
KNOWLEDGE
PHARMACIES
MINISTRY OF HEALTH
DISEASES
MILLENNIUM DEVELOPMENT GOAL
PREGNANCIES
TRAINING
STERILIZATION
PATIENT
INTERVENTION
SEXUAL PARTNER
HEALTH INDICATORS
HEALTH SYSTEMS
REPRODUCTIVE HEALTH CARE
REFERRAL FACILITY
NATIONAL FAMILY PLANNING PROGRAMS
NURSES
STIS
HEALTH CARE SERVICES
OBSERVATION
VIOLENCE
ACCESS TO HEALTH SERVICES
MARKETING
REPRODUCTIVE HEALTH COMMODITIES
SERVICE PROVIDER
SAFE MOTHERHOOD
HOUSEHOLD SURVEYS
SERVICE PROVISION
MATERNAL HEALTH OUTCOMES
COMMERCIAL SEX WORKERS
SERVICE DELIVERY
HEALTH-SECTOR
INTERVIEW
HOUSEHOLD ASSETS
MATERNAL HEALTH CARE
MORTALITY
RADIO
RISK GROUPS
RESPECT
PROGRESS
SKILLED ATTENDANT
CHILDBIRTH
DISEASE SYMPTOMS
PREGNANCY COMPLICATIONS
FOOD SECURITY
WORKERS
QUALITY OF CARE
CAESAREAN SECTION
LOW-INCOME COUNTRY
HIV
MATERNAL HEALTH SERVICES
POSTNATAL CARE
IMMUNODEFICIENCY
WOMAN
POLICY RESEARCH WORKING PAPER
POOR MATERNAL HEALTH
POLICY MAKERS
HEALTH POLICY
PURCHASING POWER
HEALTH OUTCOMES
IMPROVEMENTS IN QUALITY OF CARE
FAMILY PLANNING
SOCIAL SCIENCE
POPULATION COUNCIL
MEASUREMENT
USE OF MATERNAL HEALTH SERVICES
NUTRITION
SERVICE UTILIZATION
SERVICE QUALITY
POPULATIONS
INJURIES
QUALITY SERVICES
MALARIA
ADOLESCENTS
BULLETIN
CHILDBEARING
POLICY
WORLD HEALTH ORGANIZATION
CHILD MORTALITY
MATERNAL MORTALITY RATIO
HEALTH SYSTEM
FEMALE STERILIZATION
BABIES
DELIVERY CARE
SEX
WEIGHT
PREGNANT WOMEN
MATERNAL HEALTH
REPRODUCTIVE HEALTH SERVICES
COMMERCIAL SEX
CHILDREN
LEVEL OF EDUCATION
MORTALITY RATIO
MATERNAL DEATHS
HEALTH PROBLEMS
MIDWIVES
RURAL AREAS
NUMBER OF CHILDREN
ACCESS TO FAMILY PLANNING
SOCIAL COHESION
POPULATION
MARITAL STATUS
NEONATAL MORTALITY
POLICY RESEARCH
STRATEGY
FERTILITY
CHILD HEALTH SERVICES
WOMEN
EMERGENCY OBSTETRIC CARE
NEWBORN
FAMILY PLANNING SERVICES
EMERGENCY CARE
ADOLESCENT HEALTH
POLICY ANALYSIS
OBSTETRIC CARE
AIDS
COMPLICATIONS
HEALTH SERVICES
IMPLEMENTATION
PREGNANCY
ABORTION
NEWBORN CARE
C-SECTION
GENDER EQUALITY
NURSING
NATIONAL HEALTH SYSTEMS
SERVICE PROVIDERS
DEVELOPMENT POLICY
HUMAN DEVELOPMENT
author Obare, Francis
Okwero, Peter
Villegas, Leslie
Mills, Samuel
Bellows, Ben
author_facet Obare, Francis
Okwero, Peter
Villegas, Leslie
Mills, Samuel
Bellows, Ben
author_sort Obare, Francis
title Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme
title_short Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme
title_full Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme
title_fullStr Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme
title_full_unstemmed Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme
title_sort increased coverage of maternal health services among the poor in western uganda in an output-based aid voucher scheme
publisher World Bank, Washington, DC
publishDate 2016-06
url http://documents.worldbank.org/curated/en/2016/06/26506638/increased-coverage-maternal-health-services-among-poor-western-uganda-output-based-aid-voucher-scheme
https://hdl.handle.net/10986/24626
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spelling dig-okr-10986246262024-08-07T19:54:36Z Increased Coverage of Maternal Health Services among the Poor in Western Uganda in an Output-Based Aid Voucher Scheme Obare, Francis Okwero, Peter Villegas, Leslie Mills, Samuel Bellows, Ben POPULATION STRATEGY CHILD HEALTH RISKS ADOLESCENT REPRODUCTIVE HEALTH REPRODUCTIVE HEALTH NORMAL DELIVERIES SEX WORKERS LOCAL POPULATION QUALITY OF SERVICES MATERNAL MORBIDITY CONTRACEPTION INFORMED CONSENT SKILLED HEALTH PERSONNEL EMPOWERMENT OF WOMEN FAMILY PLANNING PROGRAM ANTENATAL CARE QUALITY OF HEALTH CARE LOW-INCOME POPULATIONS LIVE BIRTHS MORBIDITY SEXUALLY TRANSMITTED DISEASES REDUCING MATERNAL MORTALITY DEVELOPING COUNTRIES PUBLIC SERVICES HOME DELIVERIES HEALTH CARE DRUGS ACQUIRED IMMUNODEFICIENCY SYNDROME NATIONAL FAMILY PLANNING SEXUALLY TRANSMITTED INFECTIONS HEALTH POLICY DISCUSSIONS REPRODUCTIVE HEALTH INDICATORS PROVISION OF SERVICES DELIVERY COSTS HYPERTENSION IMPROVING HEALTH CARE FAMILY PLANNING PROGRAMS HEALTH FACILITIES HOSPITAL PUBLIC HEALTH LIFE EXPECTANCY MATERNAL MORTALITY INEQUITIES HEALTH SECTOR KNOWLEDGE PHARMACIES MINISTRY OF HEALTH DISEASES MILLENNIUM DEVELOPMENT GOAL PREGNANCIES TRAINING STERILIZATION PATIENT INTERVENTION SEXUAL PARTNER HEALTH INDICATORS HEALTH SYSTEMS REPRODUCTIVE HEALTH CARE REFERRAL FACILITY NATIONAL FAMILY PLANNING PROGRAMS NURSES STIS HEALTH CARE SERVICES OBSERVATION VIOLENCE ACCESS TO HEALTH SERVICES MARKETING REPRODUCTIVE HEALTH COMMODITIES SERVICE PROVIDER SAFE MOTHERHOOD HOUSEHOLD SURVEYS SERVICE PROVISION MATERNAL HEALTH OUTCOMES COMMERCIAL SEX WORKERS SERVICE DELIVERY HEALTH-SECTOR INTERVIEW HOUSEHOLD ASSETS MATERNAL HEALTH CARE MORTALITY RADIO RISK GROUPS RESPECT PROGRESS SKILLED ATTENDANT CHILDBIRTH DISEASE SYMPTOMS PREGNANCY COMPLICATIONS FOOD SECURITY WORKERS QUALITY OF CARE CAESAREAN SECTION LOW-INCOME COUNTRY HIV MATERNAL HEALTH SERVICES POSTNATAL CARE IMMUNODEFICIENCY WOMAN POLICY RESEARCH WORKING PAPER POOR MATERNAL HEALTH POLICY MAKERS HEALTH POLICY PURCHASING POWER HEALTH OUTCOMES IMPROVEMENTS IN QUALITY OF CARE FAMILY PLANNING SOCIAL SCIENCE POPULATION COUNCIL MEASUREMENT USE OF MATERNAL HEALTH SERVICES NUTRITION SERVICE UTILIZATION SERVICE QUALITY POPULATIONS INJURIES QUALITY SERVICES MALARIA ADOLESCENTS BULLETIN CHILDBEARING POLICY WORLD HEALTH ORGANIZATION CHILD MORTALITY MATERNAL MORTALITY RATIO HEALTH SYSTEM FEMALE STERILIZATION BABIES DELIVERY CARE SEX WEIGHT PREGNANT WOMEN MATERNAL HEALTH REPRODUCTIVE HEALTH SERVICES COMMERCIAL SEX CHILDREN LEVEL OF EDUCATION MORTALITY RATIO MATERNAL DEATHS HEALTH PROBLEMS MIDWIVES RURAL AREAS NUMBER OF CHILDREN ACCESS TO FAMILY PLANNING SOCIAL COHESION POPULATION MARITAL STATUS NEONATAL MORTALITY POLICY RESEARCH STRATEGY FERTILITY CHILD HEALTH SERVICES WOMEN EMERGENCY OBSTETRIC CARE NEWBORN FAMILY PLANNING SERVICES EMERGENCY CARE ADOLESCENT HEALTH POLICY ANALYSIS OBSTETRIC CARE AIDS COMPLICATIONS HEALTH SERVICES IMPLEMENTATION PREGNANCY ABORTION NEWBORN CARE C-SECTION GENDER EQUALITY NURSING NATIONAL HEALTH SYSTEMS SERVICE PROVIDERS DEVELOPMENT POLICY HUMAN DEVELOPMENT Vouchers stimulate demand for health care services by giving beneficiaries purchasing power. In turn, health facilities’ claims are reimbursed for providing beneficiaries with improved quality of health care. Efficient strategies to generate demand from new, often poor, users and supply in the form of increased access and expanded scope of services would help move Uganda away from inequity and toward universal health care. A reproductive health voucher program was implemented in 20 western and southwest Ugandan districts from April 2008 to March 2012. Using three years of data, this impact evaluation study employed a quasi-experimental design to examine differences in utilization of health services among women in voucher and nonvoucher villages. Two key findings were a 16-percentage-point net increase in private facility deliveries and a decrease in home deliveries among women who had used the voucher, indicating the project likely made contributions to increase private facility births in villages with voucher clients. No statistically significant difference was seen between respondents from voucher and nonvoucher villages in the use of postnatal care services, or in attending four or more antenatal care visits. A net 33-percentage-point decrease in out-of-pocket expenditure at private facilities in villages with voucher clients was found, and a higher percentage of voucher users came from households in the two poorest quintiles. The greater uptake of facility births by respondents in voucher villages compared with controls indicates that the approach has the potential to accelerate service uptake. A scaled program could help to move the country toward universal coverage of maternal health care. 2016-07-07T16:00:11Z 2016-07-07T16:00:11Z 2016-06 Working Paper Document de travail Documento de trabajo http://documents.worldbank.org/curated/en/2016/06/26506638/increased-coverage-maternal-health-services-among-poor-western-uganda-output-based-aid-voucher-scheme https://hdl.handle.net/10986/24626 English en_US Policy Research Working Paper;No. 7709 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank application/pdf World Bank, Washington, DC