Maternal and Child Health Out-of-Pocket Expenditure and Service Readiness in Lao PDR : Evidence for the National Free Maternal and Child Health Policy from a Household and Health Center Survey (2013 Update)

World Bank Group

World Bank, Washington, DC

关键词: prenatal care;    maternal health;    health expenditure;    health centers;    health systems reform;   

RP-ID  :  107281

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Lao PDR has made notable progress inimproving maternal health, with mater¬nal mortalitydecreasing from 1,600 per 100,000 births in 1990 to 220 in2013.1 However, in order for further gains to be realized,at least two barriers need to be addressed – the lowutilization of maternal health (MH) services and weakfinancial protection, especially among the lower wealthquintiles, in order to improve the level and equity ofmaternal health. In order to address these financialbarriers, the Government of Lao PDR introduced a nationalfree maternal and child health (MCH) policy. Although therewere geographic variations in the operationalization of thispolicy,4 the essence is that user fees paid OOP by pregnantwomen or for children under-five were replaced withcase-based payments paid by or through the government ordonors, for essential MCH services. In addition, small cashpayments were provided to patients to cover opportunity andtransport costs. This report summarizes key findings fromtwo household, village, and health center surveys insouthern and rural Lao PDR conducted in 2010 and 2013,providing for the first time in Lao PDR, large-scalehousehold-level data on OOP expenditure for MCH-specific services.