Table 3 Key design features
From: A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya
Key features | Characteristics |
|---|---|
1. Benefit package | |
Safe motherhood (SM) | |
Management of labour and complications | ✓ Delivery- vacuum extraction and caesarean care |
✓ Emergency obstetric care; manage all stages of labour | |
✓ Refer for emergency obstetric care services | |
✓ Management of postpartum hemorrhage, eclampsia but not abortion related issues | |
✓ Management of retained placenta, prolonged labour/obstructed, ruptured uterus. | |
✓ Four ANC visits | |
Post natal care | ✓ Within six hours of delivery examination of clients for danger signs |
✓ Referral for postpartum hemorrhage, third degree tear | |
✓ Newborn care and referral for sick new born | |
✓ Post operative care for Caesarean section | |
✓ Review mother and counsel on infant feeding practices | |
✓ Contraception and PMTCT services | |
Long term Family planning methods | ✓ Long-term contraception methods but at present underutilized- implants, IUCD, male and female voluntary surgical contraception |
Gender based violence | ✓ Medical examination and treatment and management of injuries |
✓ Hospitalization and accommodation | |
✓ Laboratory testing and X-rays including (HIV/AIDS, High Vaginal Swab, Hepatitis, Pregnancy, Syphilis, Urinalysis, Haemogram, Liver Function | |
✓ Access to pregnancy prevention medication & antiretroviral drugs | |
✓ Professional counselling | |
2. Quality Assurance | |
Infrastructure and basic services | ✓ Facilities with basic equipment and infrastructure and staff according to the level of care |
✓ Provision of basic emergency and comprehensive obstetric care | |
Monitoring quality | ✓ Documentation of treatment given including filling in the partograph, patient file notes and register |
✓ Documentation to facilitate reimbursements and claims | |
✓ Analysis of claims data regularly every three months | |
3. Selection of facilities and accreditation process | |
Selection of providers | ✓ Mapping of facilities in selected districts based on level of care and service given (basic and comprehensive obstetric care) and licensed service providers |
✓ Selection made by an assessor using set criteria | |
Contracting providers and distributors | ✓ Contractual agreements with selected VSPs and distributors |
4. Marketing and distribution | |
Distribution process | ✓ Two mechanisms used; direct approach distribution where vouchers are sold to clients in their homes; use of specific locations- where clients will go to specific points to access the vouchers such as preferred fixed selling points such as pharmacies. |
Marketing strategy | ✓ Designed to use local media, radio shows, vans buses, fliers and posters and marketed as VOCHA brand |
5. Claims and reimbursement process | |
Claims processing | ✓ Time line pegged at a month from presenting claim with proper documentation |
Reimbursement | ✓ Reimbursement fee set based on a market analysis of what different facilities charged and negotiated |
6. Management system | ✓ System of managing program with clearly defined roles |