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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A policy analysis of the implementation of a reproductive health vouchers program in Kenya
BMC Public Health, Volume 12, No. 1, Article 540, Year 2012
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Description
Background: Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods. Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results: The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions: OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The governments role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies. © 2012 Abuya et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Abuya, Timothy O.
Kenya, Nairobi
Population Council Nairobi
Njuki, Rebecca
Kenya, Nairobi
Population Council Nairobi
Warren, Charlotte E.
Kenya, Nairobi
Population Council Nairobi
Okal, Jerry O.
Kenya, Nairobi
Population Council Nairobi
Obare, Francis O.
Kenya, Nairobi
Population Council Nairobi
Kanya, Lucy W.
Kenya, Nairobi
Population Council Nairobi
Askew, Ian D.
Kenya, Nairobi
Population Council Nairobi
Bellows, Benjamin W.
Kenya, Nairobi
Population Council Nairobi
Statistics
Citations: 57
Authors: 8
Affiliations: 1
Identifiers
Doi:
10.1186/1471-2458-12-540
e-ISSN:
14712458
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Approach
Qualitative
Study Locations
Kenya