Using vouchers to increase access to maternal healthcare in Bangladesh

Int Q Community Health Educ. 2009-2010;30(4):293-309. doi: 10.2190/IQ.30.4.b.


The maternal mortality ratio (322) is comparatively high in Bangladesh. The utilization of maternity care provided by trained professionals during and after delivery is alarmingly low, primarily due to lack of knowledge and money. The overall objective of this operations research project was to test the feasibility and effectiveness of introducing financial support (voucher scheme) for poor rural women to improve utilization of antenatal care (ANC), delivery and postnatal check-up (PNC) from trained service providers. A pretest-posttest design was utilized. A total of 436 women were interviewed before and 414 after the intervention to evaluate the impact of interventions. In-depth interviews were conducted with users and non-users of vouchers. Findings show that institutional deliveries have increased from 2% to 18%. Utilization of ANC from trained providers has increased from 42% to 89%. Similarly, utilization of PNC from trained providers has increased from 10% to 60%.

MeSH terms

  • Adult
  • Bangladesh
  • Cross-Sectional Studies
  • Delivery, Obstetric / methods
  • Female
  • Health Services Accessibility / economics*
  • Health Services Accessibility / organization & administration
  • Humans
  • Maternal Health Services / economics*
  • Maternal Health Services / organization & administration
  • Maternal Health Services / statistics & numerical data*
  • Maternal Mortality
  • Medical Assistance / organization & administration*
  • Medical Assistance / statistics & numerical data*
  • Poverty Areas
  • Rural Population / statistics & numerical data
  • Socioeconomic Factors
  • Transportation