Mid-term review of Maternal and Child Health Voucher Scheme

     During May 2010 to March 2011, a feasibility study of the community health initiative for MCH care was conducted in the Lewe, Yedarshey and Tatkone Townships by HITAP, the WHO and the MoH, Myanmar. The first study mission in May 2010 developed a protocol for the community health initiative which was technically and financially feasible, acceptable among stakeholders, and also relevant to the country context. The second mission was conducted in August 2010 to assess the budgetary requirements for the newly designed community health initiative. The last mission, conducted during March 2011, estimated the potential cost and health outcomes from the future implementation of the community health initiative and devised a system and mechanism for its monitoring and evaluation through the use of a decision analytics model.

     The results from this study showed that the MCHVS was feasible and had a good chance of being implemented in Myanmar with the aim of increasing the service utilisation of ANC and delivery by SBAs, especially for poor households. Demand-side financing under the programme was also expected to eliminate any provider fees and other household expenses related to the use of MCH services. If pregnant women had the choice of using MCH vouchers at any health facility and there were enough incentives for providers to offer to voucher holders, it should promote the quality of MCH services and reduce both neonatal and maternal mortality .

     After the study, the guidelines for the MCHVS were developed in collaboration by the MoH and HITAP and the responsibilities for further implementation of the scheme were transferred solely to the MoH. The guidelines consisted of four sections including: voucher distribution guidelines; financial management guidelines; communication guidelines; and monitoring and evaluation guidelines. Once the guidelines were approved, the MCHVS pilot programme was initiated in Yedarshey Township on 11 May 2013 after much preparation and advocacy.

     Since the launch of the MCHVS programme in Yedarshey Township, the Health Planning Unit of the Department of Health (DoH) has been responsible for taking care of the implementation procedures directly from the central level and a National Finance Officer from the WHO has been working in the field to help facilitate and closely monitor the process. Six months after the programme’s commencement, the WHO and MoH have requested to see the current process being used according to the guidelines and the present utilisation status of the MCHVS. Thus, HITAP was once again invited to conduct a mid-term review by the WHO and the Health Planning Unit of the DoH from 21 – 23 January 2014.