Vouchers: A Hot Ticket for Reaching the Poor and Other Special Groups With Voluntary Family Planning Services

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FIGURE 1.
How Does It Work? A Flow Diagram of Voucher Transactions
Source: Adapted from the World Bank 2005,³ Islam 2006,⁴ and Grainger et al. 2014.¹
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FIGURE 2.
Key Features of a Voucher System

TABLE Key Advantages and Challenges of Voucher Programs

Advantages	Challenges
Reduce financial and other client barriers to accessing health services.	Require establishment of systems and processes to execute and monitor program.
Allow governments and donors to target subsidies for populations in need, such as poor, youth, and pregnant or postpartum women.	Can be complex to target to defined groups, particularly for groups new to vouchers. Requires measures to mitigate fraud and leakage to general population or non-poor.
Allow resources to be directed toward key or high-impact health interventions and can stimulate demand for health services and behaviors.	Unclear how they may affect other health services and the overall health system; could result in provider overload if the system is not prepared.
Create a network of quality-assured health care providers, which can enhance access to services in the short term, and a platform for strategic purchasing in medium to longer term.	Require quality inputs to service providers to improve quality of care; quality inputs also prevent driving up service use without improving health outcomes and client satisfaction.
Voucher revenue can flow directly to health care providers, which the providers can then reinvest in facilities and services to further improve them.	Program funding may or may not be used to invest in areas that improve services or client satisfaction.