Abstract

Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015.Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the intended target group. MSM's youth voucher program has revealed a high demand for voluntary family planning services, especially among youth under 20 years old, and MSM has since integrated the youth voucher beyond the initial pilot locations. MSM's experience indicates that youth vouchers are a novel and effective means of increasing young people's access to voluntary family planning services in Madagascar, and this model could potentially be replicated or adapted in other contexts where young people are faced with barriers to accessing quality information and services.

Highlights

  • Vouchers offer opportunities to reach specific groups of people with health services by removing financial barriers.[1,2] The services provided with vouchers areYouth Voucher Program in Madagascar www.ghspjournal.org typically highly specified—for example, family planning services—but generally allow the user to choose from a range of providers using a reimbursable token, often in paper form but sometimes digital.The use of vouchers to support access to contraceptives can be traced back to Taiwan in the 1960s, where subsidized coupons were introduced to partially reimburse private-sector physicians for providing contraceptives under the national family planning program.[3]

  • The approach was slow to expand to other countries, there has been increased experimentation with voucher programs since 2000, with at least 30 programs in developing countries identified in a 2011 review of the use of vouchers in sexual and reproductive health (SRH) programs.[4]

  • A recent systematic review of evaluations of family planning voucher programs identified only 2 studies of such programs: one in Vietnam focused on young people and another in Nicaragua focused on adolescents

Read more

Summary

Introduction

Vouchers offer opportunities to reach specific groups of people with health services by removing financial barriers.[1,2] The services provided with vouchers areYouth Voucher Program in Madagascar www.ghspjournal.org typically highly specified—for example, family planning services—but generally allow the user to choose from a range of providers using a reimbursable token, often in paper form but sometimes digital.The use of vouchers to support access to contraceptives can be traced back to Taiwan in the 1960s, where subsidized coupons were introduced to partially reimburse private-sector physicians for providing contraceptives under the national family planning program.[3]. Vouchers offer opportunities to reach specific groups of people with health services by removing financial barriers.[1,2] The services provided with vouchers are. A recent systematic review of evaluations of family planning voucher programs identified only 2 studies of such programs: one in Vietnam focused on young people and another in Nicaragua focused on adolescents. No studies were identified on family planning voucher programs that focused on adolescents or young people in sub-Saharan Africa.[5]. Young people often express a preference for seeking family planning information and services from the private sector. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention—youth-friendly social franchisee training and quality monitoring —with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people

Methods
Results
Discussion
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call