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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 Open the ORCID record for Mohammad Nahid Mia [Opens in a new window] ,
Shehrin Shaila Mahmood ,
Mohammad Iqbal ,
Abbas Bhuiya ,
Saseendran Pallikadavath Open the ORCID record for Saseendran Pallikadavath [Opens in a new window]  and
William Stones
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
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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.

Keywords

Antenatal CareDemand-side FinancingLow Performing area in Bangladesh
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 2 , March 2022 , pp. 217 - 224
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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