Findings of an 18-Month Assessment of the Effectiveness of a Rural-Based Social Franchising Programme Using Vouchers of Long-Term Family Planning Services in Pakistan
Introduction: Nearly 14,000 women die each year in Pakistan from causes related to pregnancy. This number is projected to have been 1.7 times higher without contraceptive practice. Family planning is known to be one of the most cost-effective ways to reduce maternal deaths, but currently only 29.3% use contraceptives. This paper evaluates the effectiveness of a two pronged approach using social franchising and vouchers designed to increase contraceptive utilization, especially long term birth spacing methods, among underserved women in rural areas of Pakistan where the use of contraceptives is very low in order to improve maternal health. Methods: A quasi-experimental study design with controls was used. One intervention and one control district were purposely (based on socio-demographic and reproductive health indicators) selected each from two provinces of Pakistan; and each district had a total of four providers. All providers in intervention groups were franchised, trained, and have demand generated through field workers (social franchising intervention) and vouchers (free voucher intervention); while control providers continued with their routine practices without changes. A population-based, cross-sectional survey was carried out among 4992 married women of reproductive age group (MWRA) in Feb 2009 within the catchment areas of each provider and after 18 months, an endline survey was conducted among 4003 MWRA. Multiple logistic regressions were used to estimate net effect (difference in intervention difference in control) using STATA 11.2. Results: The intervention significantly increased the awareness of modern contraception by 5% (p-value <0.001) when adjusted for control. The ever use of modern contraceptive was increased by 28.5% (p-value <0.001). A substantial increase of 19.6% (p-value <0.001) was observed in contraceptive prevalence, with modern contraceptive use increasing by 22.7% (p-value <0.001); while the use of traditional method was reduced by 3% (p-value <0.001). Among modern methods, the highest change was recorded in IUCD with 11.1% (p-value <0.001) as the intervention was promoting long-term method use; and among IUCD users 76.4% had it inserted from Suraj SF centre including 34.7% women who received it through vouchers of all women interviewed, nearly 28% reported that they had received contraceptive services from MSS social franchise provider and were referred by MSS demand generation field workers including: 8.9% with voucher (for IUCD) and nearly 20% without voucher (for any contraceptive service). Conclusion: The two-pronged social franchising approach implemented by MSS Pakistan, that generates demand (field workers and vouchers) and addresses the supply gap (trained providers), can effectively increase awareness and uptake of contraceptives that would ultimately improve maternal health
Year of publication: |
2014
|
---|---|
Authors: | Azmat, Syed Khurram |
Publisher: |
[S.l.] : SSRN |
Subject: | Pakistan | Franchising | Fertilität | Fertility | Gutscheinsystem | Voucher programme |
Saved in:
freely available
Extent: | 1 Online-Ressource (21 p) |
---|---|
Series: | Research, Monitoring & Evaluation Working Paper Series ; No. 3, 2012 |
Type of publication: | Book / Working Paper |
Language: | English |
Notes: | Nach Informationen von SSRN wurde die ursprüngliche Fassung des Dokuments February 18, 2013 erstellt |
Other identifiers: | 10.2139/ssrn.2292298 [DOI] |
Source: | ECONIS - Online Catalogue of the ZBW |
Persistent link: https://www.econbiz.de/10014155799
Saved in favorites
Similar items by subject
-
School vouchers, labor markets and vocational education
Bettinger, Eric, (2019)
-
Liverpool-Tasie, Lenis Saweda, (2012)
-
Input promotion within a complex subsector : fertilizer in Nigeria
Liverpool-Tasie, Lenis Saweda, (2013)
- More ...
Similar items by person