259594 Expanding universal coverage: Reproductive health vouchers in Cambodia

Monday, October 29, 2012 : 2:30 PM - 2:45 PM

Carinne Brody, DrPH , Public Health Program, Touro University California, Vallejo, CA
Julie Freccero, MPH , School of Public Health, Uc Berkeley, Berkeley, CA
Ben Bellows, MPH , Population Council, Nairobi, Kenya
Claire Brindis, DrPH , Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
One approach to delivering healthcare in developing countries is through voucher programs, where vouchers are distributed to a specific population for free or subsidized health care. Recent evaluations suggest that vouchers have the potential to extend coverage of priority health services to the poor in developing countries. In Cambodia, a reproductive health voucher program was implemented in January 2011. This study aims to explore women's experiences accessing services with their vouchers at accredited clinics. This qualitative study used focus group methodology to gather information from both older (>25 yrs) and younger (18-25 yrs) women who were eligible for the voucher program in three provinces. Focus groups were digitally recorded, transcribed and translated from Khmer into English. Data analysis was an iterative process, which comprised of the development of a conceptual framework during data collection, careful coding of all transcripts, and the generation of themes, categories and sub-categories. Two overarching themes were identified in the data: 1) factors that facilitate voucher use and 2) factors that inhibit voucher use. Within each of these themes, three subthemes were identified: 1) pre-existing factors, 2) distribution factors and 3) redemption factors. Overall, women expressed positive feelings towards the voucher program, reporting that they now sought earlier and more frequent care. Several important areas for program improvement were identified such as better counseling during voucher distribution and addressing informal payments expected by midwives despite voucher use. Early information from program beneficiaries can lead to timely and responsive changes that can help to maximize program success.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
Describe the role of voucher programs in extending coverage of priority health services to the poor in developing countries Identify the factors that impact the use of voucher by poor women in Cambodia

Keywords: Reproductive Health Research, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-principal investigator on several grants evaluating health voucher programs. I have presented results from other evaluations at international conferences. My research and teaching areas for the past 5 years have been focused on extending access to reproductive health services globally.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.