Information of using voucher approach in NACP III

[Guest guest]

Dear Colleagues and Friends

Output-Based Aid (OBA) is a relatively noble approach to financing and

delivering service. Voucher schemes to generate demand have used in several

Asian countries.

The OBA voucher approach clearly recognises the growing importance of the

private sector to reach the public health objectives.

The basic idea of OBA is to delegate specific services to certified health care

providers under contracts that link payments on certain output and results for

specific target group.

Voucher programs, if well designed and administered can help to

achieve a broad range of common policy goals: improving equity,

efficiency, quality and access to services.

The Output based voucher concept envisages financing agreed outputs,

rather than pre-defined inputs, by selling vouchers to the

beneficiaries at subsidized price. However, voucher approach have the

potential to increase use of services by target populations, engage

the private providers, increase competition, and improve quality of

service by providers.

Specific marginalised groups can be targeted that share a

characteristic or have an identifiable illness, for example infant

and young children with specific age group, pregnant women, high risk

groups such as sex workers for STIs, etc. and can redeem the vouchers

in exchange for pre defined services like STI diagnosis and

treatment, delivery assisted by skilled health personnel, VCTC etc.

in certified health facilities.

Such schemes overcome the problem of access to cash because they do not require

any advance payment for care. A small number of successful examples of running

voucher schemes (e.g. RH/FP including maternal health: in Bangladesh, China,

Kenya, cash subsidies to pregnant women for institutional delivery in AP, India

and insecticide-treated bed nets for pregnant women and

children in Tanzania).

A competitive voucher scheme has been shown to be an effective means of reaching

high-risk groups and providing good quality of diagnosis and treatment of STIs

in Nicaragua and Uganda.

As we all know that private sector plays a dominant role in the

delivery of medical and health care services in India. It is

estimated that more than 80 per cent of the people use the private

sector for outpatient care and more than 50 per cent for in-patient

care.

Therefore, I am very much interested to learn from you all that is

there any initiatives undertaken in NACP III or any other initiatives

following the OBA Voucher approach in reaching and targeting people

particularly engaging private sector providers who plays significant

role in primary health care.

Look forward to learn from your experiences.

Biswajit Panda

e-mail: biswajit71@...

Mobile: 0091-9433141853