Publication: Maternal and Child Health Out-of-Pocket Expenditure and Service Readiness in Lao PDR: Evidence for the National Free Maternal and Child Health Policy from a Household and Health Center Survey (2013 Update)
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2016-05-01
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2016-08-25
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Lao PDR has made notable progress in improving maternal health, with mater¬nal mortality decreasing from 1,600 per 100,000 births in 1990 to 220 in 2013.1 However, in order for further gains to be realized, at least two barriers need to be addressed – the low utilization of maternal health (MH) services and weak financial protection, especially among the lower wealth quintiles, in order to improve the level and equity of maternal health. In order to address these financial barriers, the Government of Lao PDR introduced a national free maternal and child health (MCH) policy. Although there were geographic variations in the operationalization of this policy,4 the essence is that user fees paid OOP by pregnant women or for children under-five were replaced with case-based payments paid by or through the government or donors, for essential MCH services. In addition, small cash payments were provided to patients to cover opportunity and transport costs. This report summarizes key findings from two household, village, and health center surveys in southern and rural Lao PDR conducted in 2010 and 2013, providing for the first time in Lao PDR, large-scale household-level data on OOP expenditure for MCH-specific services.
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“World Bank Group. 2016. Maternal and Child Health Out-of-Pocket Expenditure and Service Readiness in Lao PDR: Evidence for the National Free Maternal and Child Health Policy from a Household and Health Center Survey (2013 Update). © World Bank. http://hdl.handle.net/10986/24951 License: CC BY 3.0 IGO.”
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These countries still face challenges, however, in terms of the evolving health system, and changes at the economic, social and political levels. Future qualitative and quantitative analyses on the returns of health investments, the political context and institutional arrangements at the country level could help deepen the understanding of the ways in which various countries, with their unique conditions, can improve MCH.Publication Maternal Health, Child Health and Nutrition in Lao PDR : Evidence from a Household Survey in Six Central and Southern Provinces(Washington, DC, 2013-06)Despite being on-track on the child- and maternal-health Millennium Development Goals (MDGs), Lao PDR continues to have some of the worst maternal and child health (MCH) and nutrition outcome indicators, both globally as well as in the East Asia and Pacific (EAP) region. This report presents results from a household, village, and facility survey on Maternal and Child Health (MCH) and nutrition in mostly rural areas of six central and southern provinces of Lao People's Democratic Republic (PDR). The information in this report localizes MCH and nutrition-related information that are typical for sampled catchment areas of selected health centers in six central and southern provinces of the country. In addition, the report summarizes data on service availability and readiness of health centers in terms of their ability to provide key MCH & nutrition-related services. The results from this survey thus shed light on what it would take to attain the health-related MDGs. In order to improve the level and equity of maternal and child health indicators, interventions would need to address numerous demand-side barriers, including physical access barriers, financial barriers, and cultural, linguistic, and educational barriers.
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