Utilization of quality maternal health care services through financial scheme

In Bangladesh, maternal mortality ratio (MMR) is one of the highest in the world (322/100000). There are several underlying causes that prohibit achieving millennium development goal of reducing MMR at 143 by the year 2015, and among them the important causes are lack of awareness, financial constraint and unavailability of quality maternal health care services. Several special programs have been introduced to provide subsidized health care services to the poor people in Bangladesh. Financial assistance to poor women to avail pregnancy related services was tested in this operations research project. The overall objective of the study was to test the feasibility and effectiveness of financial scheme (voucher) for poor rural women to improve utilization of ANC, delivery and PNC from trained service providers. A pretest – posttest design has been utilized. The duration of intervention was 9 months. During the intervention period, 580 pregnant poor women received vouchers from the project staff. A total 436 women were interviewed before and 414 after the intervention to evaluate the impact of interventions. In-depth interviews were conducted with voucher users and non-users. Findings suggest that institutional deliveries have increased from 2.5 percent to 20 percent. Utilization of antenatal care from trained providers has increased from 50 percent to 100 percent. Similarly, number of women attended postnatal care services also has increased from 36 percent to 64 percent. Findings also revealed that the proportion of physical and medical examinations during ANC visits has significantly increased during intervention period.