Project results show that compared to baseline, use of modern contraceptive methods increased by 30% in the intervention area as against 14% in the control area. Specifically, in the intervention area IUD use increased from 2% to 20% (national level use of IUD is 1-2%) and condom use increased from 7% to 13%. Vouchers also resulted in an increase of 16% in current contraceptive use and 26% increase in modern methods use. Intervention area also reported low method-specific discontinuation (13.7%) and high method-specific switching rates (46.6%) amongst modern contraceptive users. The corresponding figures for control area were 26.8% and 13.3% respectively. Many of those who switched to modern methods, switched to IUDs, implants, injectables and pills, which are far more effective compared to the traditional family planning methods. Also, the underserved population utilized the modern methods more than their affluent counterparts.
The study outcomes prove that vouchers increase the use of modern contraception methods (especially the long acting reversible contraception methods) along with other modern methods like pills and injectables. Vouchers also decrease discontinuation and increase switching. Voucher use seemed to reduce the inequality in access to modern methods across wealth quintiles and enhanced equity by reaching out to the poor who began using them more.
"Vouchers can be a highly effective tool to increase access to, and use of, family planning and reproductive health services. Long term use of vouchers can strengthen the health system capacity and provide a pathway to the strategic purchasing power such as insurance or contracting in the long run and contributing in the context of universal health coverage in the low and middle income countries", Dr Ali said to CNS (Citizen News Service).
The second example of innovative financing was from the Philippines on "Public-Private Partnership Bridge Funding". Loida Almendares, Programme Manager at DKT International in Philippines, shared the concept of "bridge financing".
What is bridge financing?
The Philippine Responsible Parenthood and Reproductive Health Law calls for engagement of the civil society by the government to address the unmet need for family planning. The Department of Health allocates funds for this purpose. However, the process of transferring government funds to private organizations is cumbersome and often results in delays in fund release.
Bridge financing is a mechanism to address this gap and to allow civil society organizations to implement family planning and reproductive health activities without unnecessary delays. It allows family planning services to be provided even while the government is yet to release project funds for the civil society organizations. Bridge financing is a "no interest loan" given to civil society organizations with existing project contracts and is to be strictly used for project implementation. It is to the tune of 30-35% of the total project fund. The money has to be returned to the Bridge Fund provider - which could be any financing entity - at the end of the project at zero interest. Philippines government laws support public and private partnerships or engagement of civil society organizations and private sectors to actively participate in the development processes of the state.
There could be different public-private partnership models utilising the bridge financing mechanism. Almendares shared the outcomes of one such model developed in the Philippines jointly by the Cooperative Movement for Encouraging No-Scalpel Vasectomy (CMEN), Pangasinan Province civil society organization and the government.
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