Academic Journal

Does health voucher intervention increase antenatal consultations and skilled birth attendances in Cameroon? Results from an interrupted time series analysis

التفاصيل البيبلوغرافية
العنوان: Does health voucher intervention increase antenatal consultations and skilled birth attendances in Cameroon? Results from an interrupted time series analysis
المؤلفون: Isidore Sieleunou, Roland Pascal Enok Bonong
المصدر: BMC Health Services Research, Vol 24, Iss 1, Pp 1-10 (2024)
بيانات النشر: BMC, 2024.
سنة النشر: 2024
المجموعة: LCC:Public aspects of medicine
مصطلحات موضوعية: Voucher, Results-based financing, Health financing, Antenatal consultation, Skilled birth attendance, Cameroon, Public aspects of medicine, RA1-1270
الوصف: Abstract Background Limited access to health services during the antenatal period and during childbirth, due to financial barriers, is an obstacle to reducing maternal and child mortality. To improve the use of health services in the three regions of Cameroon, which have the worst reproductive, maternal, neonatal, child and adolescent health indicators, a health voucher project aiming to reduce financial barriers has been progressively implemented since 2015 in these three regions. Our research aimed to assess the impact of the voucher scheme on first antenatal consultation (ANC) and skilled birth attendance (SBA). Methods Routine aggregated data by month over the period January 2013 to May 2018 for each of the 33 and 37 health facilities included in the study sample were used to measure the effect of the voucher project on the first ANC and SBA, respectively. We estimated changes attributable to the intervention in terms of the levels of outcome indicators immediately after the start of the project and over time using an interrupted time series regression. A meta-analysis was used to obtain the overall estimates. Results Overall, the voucher project contributed to an immediate and statistically significant increase, one month after the start of the project, in the monthly number of ANCs (by 26%) and the monthly number of SBAs (by 57%). Compared to the period before the start of the project, a statistically significant monthly increase was observed during the project implementation for SBAs but not for the first ANCs. The results at the level of health facilities (HFs) were mixed. Some HFs experienced an improvement, while others were faced with the status quo or a decrease. Conclusions Unlike SBAs, the voucher project in Cameroon had mixed results in improving first ANCs. These limited effects were likely the consequence of poor design and implementation challenges.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1472-6963
Relation: https://doaj.org/toc/1472-6963
DOI: 10.1186/s12913-024-10962-9
URL الوصول: https://doaj.org/article/34d90648e946491d8238a0b140ca654f
رقم الانضمام: edsdoj.34d90648e946491d8238a0b140ca654f
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:14726963
DOI:10.1186/s12913-024-10962-9