Effective Policy Approaches to Reach the Poor with FP/RH Services: Evidence from Jordan, Egypt, and Bangladesh

Effective programs and interventions in a number of developing countries have successfully reduced barriers to access to healthcare services among the poor and give the neediest a greater share of resources and benefits. Universal health insurance, demand-side financing, and targeted use of resources are some of the strategies that countries have used to improve access to resources and services among the poor. Some programs emphasized bringing health providers and facilities closer to communities, and, in some cases, have engaged the poor and communities in needs assessments, program design, and implementation. No single approach can address all the challenges related to limited access and use of healthcare services among the poor. Carefully thought out, evidence-based country-driven strategies are needed to ensure that health benefits and resources reach the poor and those most in need.

To understand the level of inequality and trends related to family planning access, the USAID | Health Policy Initiative conducted an analysis of 47 countries using Demographic and Health Survey (DHS) data. The project then conducted market segmentation analysis and a detailed review of the policy environment and its impact on the market in three countries where inequality has been reduced: Jordan, Egypt, and Bangladesh. The review of policy environment drew on key informant interviews; policy dialogue with government, NGO, and private sector representatives; and a review of policy documents to determine government policies concerning family planning, private sector, and the poor. Favorable policies and targeted efforts resulted in increased use of contraceptives among the poor. In Jordan, during 1997-2007, women's use of contraceptives obtained through public sector increased from 38 percent to 57 percent in the poorest quintile due to quality improvements and targeted interventions to reach the poor.