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首页> 外文期刊>BMC Health Services Research >Are family planning vouchers effective in increasing use, improving equity and reaching the underserved? An evaluation of a voucher program in Pakistan
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Are family planning vouchers effective in increasing use, improving equity and reaching the underserved? An evaluation of a voucher program in Pakistan

机译：家庭规划优惠券是否有效地越来越多地利用，改善公平和到达服务不足？巴基斯坦凭证计划的评估

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Low modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims to assess the effectiveness of a free, single-purpose voucher approach in increasing the uptake, use and better targeting of modern contraceptives among women from the lowest two wealth quintiles in rural and urban communities of Punjab province, Pakistan. A quasi-interventional study with pre- and post-phases was implemented across an intervention (Chakwal) and a control district (Bhakkar) in Punjab province (August 2012-January 2015). To detect a 15% increase in modern contraceptive prevalence rate compared to baseline, 1276 women were enrolled in each arm. Difference-in-Differences (DID) estimates are reported for key variables, and concentration curves and index are described for equity. Compared to baseline, awareness of contraceptives increased by 30 percentage points among population in the intervention area. Vouchers also resulted in a net increase of 16% points in current contraceptive use and 26% points in modern methods use. The underserved population demonstrated better knowledge and utilized the modern methods more than their affluent counterparts. Intervention area also reported a low method-specific discontinuation (13.7%) and high method-specific switching rates (46.6%) amongst modern contraceptive users during the past 24?months. The concentration index indicated that voucher use was more common among the poor and vouchers seem to reduce the inequality in access to modern methods across wealth quintiles. Vouchers can substantially expand contraceptive access and choice among the underserved populations. Vouchers are a good financing tool to improve equity, increase access, and quality of services for the underserved thus contributing towards achieving universal health coverage targets.
机译：巴基斯坦的低现代避孕流行率和高未满足的需求加剧了意外怀孕和出生促进孕产妇发病率和死亡率的脆弱性。本研究旨在评估自由，单一的凭证方法的有效性，以提高来自巴基斯坦旁遮普省普吉布布省农村和城市社区最低的两家财富昆虫的妇女的现代避孕药。在旁遮普省普京省的干预（Chakwal）和一个对照区（Bhakkar）中实施了与阶段的准介入研究（2012年8月 - 2015年8月）。与基线相比，检测现代避孕患病率的15％增加，每只臂都注册了1276名女性。报告差异差异（DID）估计对于关键变量，并针对权益描述了浓度曲线和索引。与基线相比，干预区中避孕药的意识增加了30个百分点。优惠券还导致当前避孕药中的16％净增加，现代方法使用26％。服务不足的人口表现出更好的知识，并利用了现代方法，而不是他们的富裕的对应物。干预面积还报告了在过去的24个月中的现代避孕药中的特定于特定于特定于特定于特定的中断（13.7％）和高法定的转换率（46.6％）。浓度指数表明，凭证在穷人和优惠券中更常见，凭证似乎减少了在财富昆泰跨越财富前进方法的不平等。优惠券可以大大扩大避孕人口中的避孕获取和选择。优惠券是一种良好的融资工具，可以提高股权，增加进入和服务质量，从而有助于实现普遍健康覆盖目标。

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