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Assessing the Elimination of User Fees for Delivery Services in Laos

A pilot eliminating user fees associated with delivery at the point of services was introduced in two districts of Laos in March 2009. Following two years of implementation, an evaluation was conducted to assess the pilot impact, as well as to document the pilot design and implementation challenges....

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Detalles Bibliográficos
Autores principales: Boudreaux, Chantelle, Chanthala, Phetdara, Lindelow, Magnus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954553/
https://www.ncbi.nlm.nih.gov/pubmed/24632592
http://dx.doi.org/10.1371/journal.pone.0089784
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author Boudreaux, Chantelle
Chanthala, Phetdara
Lindelow, Magnus
author_facet Boudreaux, Chantelle
Chanthala, Phetdara
Lindelow, Magnus
author_sort Boudreaux, Chantelle
collection PubMed
description A pilot eliminating user fees associated with delivery at the point of services was introduced in two districts of Laos in March 2009. Following two years of implementation, an evaluation was conducted to assess the pilot impact, as well as to document the pilot design and implementation challenges. Study results show that, even in the presence of the substantial access and cultural barriers, user fees associated with delivery at health facilities act as a serious deterrent to care seeking behavior. We find a tripling of facility-based delivery rates in the intervention areas, compared to a 40% increase in the control areas. While findings from the control region suggest that facility-based delivery rates may be on the rise across the country, the substantially higher increase in the pilot areas highlight the impact of financial burden associated with facility-based delivery fees. These fees can play an important role in rapidly increasing the uptake of facility delivery to reach the national targets and, ultimately, to improve maternal and child health outcomes. The pilot achieved important gains while relying heavily on capacity and systems already in place. However, the high cost associated with monitoring and evaluation suggest broad-scale expansion of the pilot activities is likely to necessitate targeted capacity building initiatives, especially in areas with limited district level capacity to manage funds and deliver detailed and timely reports.
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spelling pubmed-39545532014-03-18 Assessing the Elimination of User Fees for Delivery Services in Laos Boudreaux, Chantelle Chanthala, Phetdara Lindelow, Magnus PLoS One Research Article A pilot eliminating user fees associated with delivery at the point of services was introduced in two districts of Laos in March 2009. Following two years of implementation, an evaluation was conducted to assess the pilot impact, as well as to document the pilot design and implementation challenges. Study results show that, even in the presence of the substantial access and cultural barriers, user fees associated with delivery at health facilities act as a serious deterrent to care seeking behavior. We find a tripling of facility-based delivery rates in the intervention areas, compared to a 40% increase in the control areas. While findings from the control region suggest that facility-based delivery rates may be on the rise across the country, the substantially higher increase in the pilot areas highlight the impact of financial burden associated with facility-based delivery fees. These fees can play an important role in rapidly increasing the uptake of facility delivery to reach the national targets and, ultimately, to improve maternal and child health outcomes. The pilot achieved important gains while relying heavily on capacity and systems already in place. However, the high cost associated with monitoring and evaluation suggest broad-scale expansion of the pilot activities is likely to necessitate targeted capacity building initiatives, especially in areas with limited district level capacity to manage funds and deliver detailed and timely reports. Public Library of Science 2014-03-14 /pmc/articles/PMC3954553/ /pubmed/24632592 http://dx.doi.org/10.1371/journal.pone.0089784 Text en © 2014 Boudreaux et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Boudreaux, Chantelle
Chanthala, Phetdara
Lindelow, Magnus
Assessing the Elimination of User Fees for Delivery Services in Laos
title Assessing the Elimination of User Fees for Delivery Services in Laos
title_full Assessing the Elimination of User Fees for Delivery Services in Laos
title_fullStr Assessing the Elimination of User Fees for Delivery Services in Laos
title_full_unstemmed Assessing the Elimination of User Fees for Delivery Services in Laos
title_short Assessing the Elimination of User Fees for Delivery Services in Laos
title_sort assessing the elimination of user fees for delivery services in laos
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954553/
https://www.ncbi.nlm.nih.gov/pubmed/24632592
http://dx.doi.org/10.1371/journal.pone.0089784
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