TY - JOUR
T1 - Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan
AU - Broughton, Edward Ivor
AU - Hameed, Waqas
AU - Gul, Xaher
AU - Sarfraz, Shabnum
AU - Baig, Imam Yar
AU - Villanueva, Monica
N1 - Publisher Copyright:
© Copyright © 2017 Broughton, Hameed, Gul, Sarfraz, Baig and Villanueva.
PY - 2017/9/22
Y1 - 2017/9/22
N2 - Introduction: This study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF) voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016. Method: A decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs) to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program. Results: A total of 168,206 married women of reproductive age (MWRA) received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient). The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31). Conclusion: The result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.
AB - Introduction: This study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF) voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016. Method: A decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs) to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program. Results: A total of 168,206 married women of reproductive age (MWRA) received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient). The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31). Conclusion: The result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.
KW - contraception
KW - cost-effectiveness analysis
KW - family planning services
KW - Pakistan
KW - rural health services
UR - http://www.scopus.com/inward/record.url?scp=85103350251&partnerID=8YFLogxK
U2 - 10.3389/fpubh.2017.00227
DO - 10.3389/fpubh.2017.00227
M3 - Article
AN - SCOPUS:85103350251
SN - 2296-2565
VL - 5
JO - Frontiers in Public Health
JF - Frontiers in Public Health
M1 - 227
ER -
