Center for Health Market Innovations (CHMI)

Programs

Voucher scheme for Reproductive Health in Cambodia

last updated May 18, 2012

Overview

Implementing organization: 
Marie Stopes International (MSI) Cambodia
Implementation Partner(s): 
National Hospitals, Provincial Hospitals, Referral Hospitals, Private Clinics
Legal Status: 
Public-private partnership
Year Launched: 
2010
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor
Funders: 
AusAID, European Commission
Summary: 

This project aims to strengthen local authorities and non-state-actors to increase the uptake of sexual and reproductive healthcare services by piloting a voucher scheme for the poor rural communities.

Program goals/rationale: 

Sexual and reproductive health is one of other two priority programs that are mandated in the national health strategic plan. In Cambodia, a large share of service utilization is at the private sector, which accounts for nearly 80% of health care seeking. However, private sector providers are poorly regulated and the number of qualified and unqualified private facilities is increasing. The objective of voucher schemes is to utilise the large but unregulated private sector by incentivising providers to deliver key health services at greatly improved standards, and to make them affordable.

Key program components: 

The Project has launched an innovative voucher scheme offered at subsidized price for clients (mainly the poor) to improve access to long-acting and permanent contraception, as well as basic reproductive health services, at both public and private facilities.

At the supply side, MSI has contracted a referral hospital and health center. To select the participating private clinics, MSI conducted a quality assessment at numerous clinics and contracted those that meet the qualification criteria. At demand side, MSI has leveraged the Village Health Support Groups (frontline public health workers) to conduct awareness-raising campaigns on the voucher scheme. Village Health Support Groups are also responsible for distributing the vouchers to individuals who wish to take advantage of the scheme. A voucher-holder is qualified to obtain four kinds of reproductive services at contracted facilities free of charge: family planning, intra-uterus device (IUD), tubal ligation and vasectomy. At the end of every month, MSI reimburses contracted providers for each redeemed voucher.

In collaboration with relevant stakeholders, an appropriate intervention was also developed to strengthen local authorities and non-state-actors from both supply and demand ends. This included building capacity of the heathcare staff; setting out a range of standards for service providers (e.g. commune health stations and private providers), and designing and delivering information, education and communication campaigns in order to generate understanding and demand for the covered service.

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