Maternal and child health voucher scheme in Myanmar: a review of early stage implementationReportar como inadecuado

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BMC Health Services Research

, 16:600

Utilization, expenditure, economics and financing systems


BackgroundThe Maternal and Child Health Voucher Scheme MCHVS was introduced in Myanmar to address the high rate of maternal and infant mortalities. It aimed to increase access to maternal and child health MCH services by skilled birth attendants SBAs and improve the health of pregnant women and their babies. A study to pilot a voucher scheme was implemented in May 2013 in Yedarshey Township. This paper provides a report on a mid-term review of the programme after 7 months of implementation to determine the outcomes of the programme and its impediments.

MethodsQuantitative and qualitative approaches were used. Secondary quantitative data were analysed in order to measure the coverage and utilisation of the programme. Semi-structured interviews were conducted in groups and individually with 79 key informants to explore qualitative information on voucher communication, beneficiary’s identification, voucher distribution, and challenges for beneficiaries and providers under the MCHVS.

ResultsThe results showed that 63 % of eligible pregnant women who registered to the programme received voucher booklets, while the utilisation of most of the MCH services increased over time; in particular, delivery by SBAs increased significantly P < 0.01 after implementing MCHVS. Overall, the programme was implemented well in terms of promoting and communicating the programme to people in Yedarshey Township. Although a number of targeted poor pregnant women were included in the programme, some beneficiaries were overlooked for a variety of reasons. Nevertheless, both providers and beneficiaries who experienced the MCHVS service utilisation were satisfied with the programme. The evaluation indicated several programme challenges, i.e. external and internal programme communication, voluntary voucher distributor recruitment, incentive and support for voucher distributors, beneficiary screening criteria, and approaches to increase access of services for pregnant women living in remote areas.

ConclusionsGenerally, the MCHVS pilot programme is a promising initiative to increase access to and utilisation of the MCH services for pregnant women and their babies in Myanmar. However, increasing coverage of the programme and overcoming the barriers should be considered as high-priority issues that need to be addressed.

KeywordsMaternal and child health Evaluation AbbreviationsAMWsAuxiliary midwives

ANCAntenatal care

MCHMaternal and child health

MCHVSMaternal and child health voucher scheme

MMKMyanmar Kyats

MoHMinistry of Health


PNCPost-natal care

RHCsRural health centres

SBAsSkilled birth attendants

SSIsSemi-structured interviews

TBAsTraditional birth attendants

WHOWorld Health Organization

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Autor: Songyot Pilasant - Wantanee Kulpeng - Pitsaphun Werayingyong - Nattha Tritasavit - Inthira Yamabhai - Yot Teerawattananon -


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