Role of Voucher Scheme in Reducing Inequalities in the Utilization of Delivery Care Services: Evidence from Rural Bangladesh

Kaji Tamanna Keya, Population Council
Md. Noorunnabi Talukder, Population Council
Ubaidur Rob, Population Council

Demand-side financing (DSF) is common in the developing countries. For reducing financial barriers, the Ministry of Health introduced DSF program for poor expectant mothers. The objective was to assess the effect of voucher in reducing inequalities of delivery service. A quasi-experimental control group design utilizing baseline and end line surveys were employed with 6600 mothers. A wealth index was calculated using household asset and principal components analysis. Result showed that facility-based delivery increased 13 percent, utilization of public facility increased 8 percent and caesarean delivery became double in intervention areas. In endline, highest quintile had 50 percent facility delivery and 53 percent delivery by trained provider comparing to 20 percent and 21 percent in lowest quintile comparing to negligible impact of wealth in baseline. Irrespective of the interventions, poor are more likely to receive delivery care at home (equity ratio>1) and equity in the skilled delivery is subject to wealth.