Achieving Equitable Access to Family Planning and Maternal Health Services through a Voucher Scheme: The Uttarakhand Experience

Carol Shepherd, Futures Group International
Shuvi Sharma, Futures Group International

Uttarakhand, India has a MMR of 440 (GOI 2005) and is marked by poverty, low use of RCH services and under performing government health systems. There is a strong private sector that can provide health services if appropriately regulated and their services made affordable to the poor. A Voucher Scheme (VS) was piloted by in Haridwar to provide low-income women with coupons to obtain free RCH services from designated private providers over a 21-month period from 2007-2009. Providers were reimbursed on an agreed fee schedule. Pre-test (N=2278) and post-test (N=1453) surveys were conducted to measure impact. Provider quality was monitored via facility accreditation, beneficiary site visits, post-test medical audit and client satisfaction survey. The study showed that the VS increased equitable access to RCH services. This paper presents findings from these studies on the impact of the VS, which led to scale up covering nearly 60% of the state’s population.