The effects of a voucher scheme on knowledge, attitude, and practice of maternal, neonatal, and child health services among pregnant women in Lao People’s Democratic Republic
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To provide better access to maternal, newborn, and child health (MNCH) services by lowering the physical and financial barriers, the Lao People’s Democratic Republic implemented a voucher scheme in pilot districts as a supplementary component of the already implemented “Integrated Package of MNCH Services.” We examine whether the voucher scheme implementation brought about changes in knowledge, attitude, and practice of MNCH services among pregnant women in Heuamuang and Vienthong district in Huaphan province. Based on pre- and post-voucher surveys, we constructed a dataset consisting all the mothers who gave birth in the 12 months at the time of the pre-voucher survey (N=137) and pregnant women during the pre-voucher survey (N=74) who became mothers within 12 months at the time of the post-voucher survey. Our results from regression analyses show that antenatal care (ANC) visits were not significantly associated with the voucher scheme implementation after controlling for women’s socio-demographic characteristics although more knowledge and favorable attitude to the voucher scheme were associated with the implementation. The implementation was also associated with more knowledge and favorable attitudes towards delivery and postnatal care (PNC) but not to ANC. The women exposed to the voucher scheme were less likely to recognize transportation problems and their opportunity costs of a round-trip to a health center (HC) as existing barriers to MNCH services in HCs. Further study is needed to examine the effects of the voucher scheme on delivery and PNC services in health facilities.
Abstract
To provide better access to maternal, newborn, and child health (MNCH) services by lowering the physical and financial barriers, the Lao People’s Democratic Republic implemented a voucher scheme in pilot districts as a supplementary component of the already implemented “Integrated Package of MNCH Services.” We examine whether the voucher scheme implementation brought about changes in knowledge, attitude, and practice of MNCH services among pregnant women in Heuamuang and Vienthong district in Huaphan province. Based on pre- and post-voucher surveys, we constructed a dataset consisting all the mothers who gave birth in the 12 months at the time of the pre-voucher survey (N=137) and pregnant women during the pre-voucher survey (N=74) who became mothers within 12 months at the time of the post-voucher survey. Our results from regression analyses show that antenatal care (ANC) visits were not significantly associated with the voucher scheme implementation after controlling for women’s socio-demographic characteristics although more knowledge and favorable attitude to the voucher scheme were associated with the implementation. The implementation was also associated with more knowledge and favorable attitudes towards delivery and postnatal care (PNC) but not to ANC. The women exposed to the voucher scheme were less likely to recognize transportation problems and their opportunity costs of a round-trip to a health center (HC) as existing barriers to MNCH services in HCs. Further study is needed to examine the effects of the voucher scheme on delivery and PNC services in health facilities.
참고문헌 (21)
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