The Effectiveness of Vouchers: Where More Evidence is Needed
Good science requires more than just good data: we also need researchers dedicated to progress. In this two-part series, www.rhvouchers.org sits down with Carinne Brody, a DrPH student at the University of California, Berkeley who studies reproductive health voucher programs.
Brody has worked both in the field and behind the scenes reviewing and analyzing the health voucher literature. In this first post, we learn about her findings and conclusions from a 2011 review of voucher programs written for the UK’s Department for International Development (DFID). The second post will explore Brody’s time working directly with mothers in Cambodia.
The goals of health vouchers include reaching specific populations, increasing utilization, improving quality, and ultimately improving health outcomes. But do voucher programs actually achieve these goals? The conclusions of the 2011 DFID-funded review provide some insights to this question.
Brody and co-authors reported that among 24 studies evaluating 16 different health voucher programs, vouchers successfully targeted specific populations, increased health goods/service utilization, and enhanced quality improvement. The authors used a narrative synthesis approach to qualitatively summarize outcomes within five categories: targeting, utilization, efficiency, quality, and health impact.
Five main conclusions emerged:
- there is modest evidence that vouchers effectively reach specific populations
- there is insufficient evidence to determine whether vouchers deliver health goods/services more efficiently than competing health financing strategies
- there is robust evidence that vouchers increase utilization
- there is modest evidence that vouchers improve the quality of health services; and
- the evidence indicates that voucher programs do not have an impact on the health of populations; however, this last conclusion was found to be unstable in a sensitivity analysis
Read the full article here: