Vouchers for Health: A Focus on Reproductive Health and Family Planning Services

Health care policies in developing countries have traditionally focused on public financing and provision. The provision of health care in the public sector is largely financed through supplyside subsidies. Low-priced or officially free public health care was intended to ensure the entire population’s access to care. However, there now is evidence that in many developing countries, people, including many poor, seek better-quality health care in the private sector and pay out of pocket. The extra financial burden this imposes on the poor results in unequal access to care and low utilization of needed services and products, such as reproductive health/family planning (RH/FP) services and products.

In response, policymakers are trying various demand-side approaches to financing health care, that is, subsidizing the consumer of health care directly. One approach is the use of vouchers. Vouchers are targeted at identified underserved groups (such as the poor), for specific services (such as RH/FP), and usually are for use in the private sector, as public care is supposed to be free or low cost.

While some countries have run voucher programs for education or for food supplementation for the poor for many years – the U.S. Food Stamp Program is one example – significant developing country interest in vouchers for health services is more recent, with programs taking place over the past decade or less. Many of these programs have been related to RH/FP services, such as provision of antenatal care, hospital delivery, family planning counseling and products.

This primer, intended for policymakers, donors, health care practitioners, and others involved in health care policy making and planning, draws on several overview papers on vouchers programs and demand-side subsidies.

Source:
Year: