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Implementing demand side targeting mechanisms for maternal and child health-experiences from national health insurance fund program in Rungwe District, Tanzania

Bibliographic Data

ID19534141
AuthorsAugust Kuwawenaruwa (0000-0001-8459-443X, Ifakara Health Institute, corresponding author), Gemini Mtei (0000-0002-8695-8820, Ifakara Health Institute), J Baraka (0000-0003-4835-808X, Ifakara Health Institute), Kassimu Tani (0000-0003-4955-5560, Ifakara Health Institute)
Year2016
Volume12
Issue1
Pages41-41
Publication date2016-12-01
Open AccessYes
TypeARTICLE
VenueGlobalization and Health (JOURNAL)
Journal identifiersISSN: 1744-8603 • E-ISSN: 1744-8603
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12992-016-0180-x
PMID27480025
OpenAlexW2477608981
LanguageEN
Citations received2
References cited30

BACKGROUND: Low and middle income countries have adopted targeting mechanisms as a means of increasing program efficiency in reaching marginalized people in the community given the available resources. Design of targeting mechanisms has been changing over time and it is important to understand implementers' experience with such targeting mechanisms since such mechanisms impact equity in access and use of maternal health care services. METHODS: The case study approach was considered as appropriate method for exploring implementers' and decision-makers' experiences with the two targeting mechanisms. In-depth interviews in order to explore implementer experience with the two targeting mechanisms. A total of 10 in-depth interviews (IDI) and 4 group discussions (GDs) were conducted with implementers at national level, regional, district and health care facility level. A thematic analysis approach was adopted during data analysis. RESULTS: The whole process of screening and identifying poor pregnant women resulted in delay in implementation of the intervention. Individual targeting was perceived to have some form of stigmatization; hence beneficiaries did not like to be termed as poor. Geographical targeting had a few cons as health care providers experienced an increase in workload while staff remained the same and poor quality of information in the claim forms. However geographical targeting increase in the number of women going to higher level of care (district/regional referral hospital), increase in facility revenue and insurance coverage. CONCLUSION: Interventions which are using targeting mechanisms to reach poor people are useful in increasing access and use of health care services for marginalized communities so long as they are well designed and beneficiaries as well as all implementers and decision makers are involved from the very beginning. Implementation of demand side financing strategies using targeting mechanisms should go together with supply side interventions in order to achieve project objectives

Business · Economic growth · Economics · Environmental health · Health care · Health facility · Health services research · Political science · Population · Psychological intervention · Public health · Qualitative research · Referral · Revenue · Socioeconomics · Tanzania · Thematic analysis · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Nursing · Poverty, Education, and Child Welfare · Finance · Health Policy

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Citations per year0.25
Citation span2018 - 2020 (3)
Highly citedNo

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