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首页> 外文期刊>International journal for equity in health >Changes in the proportion of facility-based deliveries and related maternal health services among the poor in rural Jhang, Pakistan: results from a demand-side financing intervention
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Changes in the proportion of facility-based deliveries and related maternal health services among the poor in rural Jhang, Pakistan: results from a demand-side financing intervention

机译：巴基斯坦张市农村贫困人口中基于设施的分娩和相关孕产妇保健服务比例的变化：需求方筹资干预的结果

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Background Demand-side financing projects are now being implemented in many developing countries, yet evidence showing that they reach the poor is scanty. Methods A maternal health voucher scheme provided voucher-paid services in Jhang, a predominantly rural district of Pakistan, during 2010. A pre-test/post-test quasi-experimental design was used to assess the changes in the proportion of facility-based deliveries and related maternal health services among the poor. Household interviews were conducted with randomly selected women in the intervention and control union councils, before and after the intervention. A strong outreach model was used. Voucher promoters were given basic training in identification of poor women using the Poverty Scorecard for Pakistan, in the types of problems women could face during delivery, and in the promotion of antenatal care (ANC), institutional delivery and postnatal care (PNC). Voucher booklets valued at Rs. 4,000 ($48), including three ANC visits, a PNC visit, an institutional delivery, and a postnatal family planning visit, were sold for Rs. 100 ($1.2) to low-income women targeted by project outreach workers. Women suffering from complications were referred to emergency obstetric care services. Analysis was conducted at the bivariate and the multivariate levels. At the multivariate level, logistic regression analysis was conducted to determine whether the increase in institutional delivery was greater among poor women (defined for this study as women in the fourth or fifth quintiles) relative to non-poor women (defined for this study as women in the first quintile) in the intervention union councils compared to the control union councils. Results Bivariate analysis showed significant increases in the institutional delivery rate among women in the fourth or fifth wealth quintiles in the intervention union councils but no significant changes in this indicator among women in the same wealth quintiles in the control union councils. Multivariate analysis showed that the increase in institutional delivery among poor women relative to non-poor women was significantly greater in the intervention compared to the control union councils. Conclusions Demand-side financing projects using vouchers can be an effective way of reducing inequities in institutional delivery.
机译：背景技术需求方融资项目目前正在许多发展中国家实施，但是有证据表明，这些项目能够惠及穷人。方法2010年期间，孕产妇保健券计划在巴基斯坦主要的农村地区张市提供了代金券有偿服务。采用了测试前/测试后的准实验设计来评估基于设施的分娩比例的变化穷人之间的相关孕产妇保健服务。在干预前后，在干预和控制工会理事会中对随机选择的妇女进行了家庭访谈。使用了强大的宣传模型。对代金券的发起人进行了基础培训，以使用巴基斯坦的贫困记分卡识别贫困妇女，妇女在分娩过程中可能面临的问题类型以及促进产前保健（ANC），机构分娩和产后保健（PNC）。凭证小册子的价值为Rs。 4,000卢比（48美元），包括3次ANC访问，PNC访问，机构分娩和产后计划生育访问，售价为Rs。 100美元（1.2美元）给以项目外展工作者为目标的低收入妇女。患有并发症的妇女被转诊至紧急产科护理服务。分析在双变量和多变量水平上进行。在多变量水平上，进行了逻辑回归分析，以确定相对于非贫困妇女（本研究定义为女性），贫困妇女（本研究定义为第四或第五个五分位数的妇女）的机构分娩增加是否更大在第一个五分位数中）与干预性工会理事会相比。结果双变量分析显示，干预工会理事会中处于第四或第五个财富五分位数的女性的机构交付率显着提高，但控制工会理事会中处于相同财富五分位数的女性的这一指标没有显着变化。多变量分析表明，与控制工会理事会相比，在干预措施中，相对于非贫困妇女，贫困妇女的机构交付量明显增加。结论使用凭证的需求方融资项目可以是减少机构交付中不平等现象的有效方法。

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