ArticleBMC health services research2019
Are family planning vouchers effective in increasing use, improving equity and reaching the underserved? An evaluation of a voucher program in Pakistan.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The sex effect: the prevalence of sex life reasons for contraceptive discontinuation. A systematic review and meta-analysis.Sexual and reproductive health matters · 2025Pooled it
- Effective strategies for increasing the uptake of modern methods of family planning in South Asia: a systematic review and meta-analysis.BMC women's health · 2024Pooled it
- Implementation strategies, facilitators, and barriers to scaling up and sustaining demand generation in family planning, a mixed-methods systematic review.BMC women's health · 2023Pooled it
- Impact of integrating family planning with maternal and child health on uptake of contraception: A quasi-experimental study in rural, Sindh, Pakistan.PLOS global public health · 2025Article
- Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- A study protocol for integrating outpatient services at the primary health care level as part of the universal health coverage benefit package within the national health insurance program of Pakistan through private health facilities.Frontiers in public health · 2024Article
- Assessing the sustainability of two independent voucher-based family planning programs in Pakistan: a 24-months post-intervention evaluation.Contraception and reproductive medicine · 2023Article
- Choices and Challenges: Visualizing Contraceptive Use Dynamics Data in 15 Low- and Middle-Income Countries.Global health, science and practice · 2023Article
- Article
- Use of implementation science to advance family planning programs in low- and middle-income countries: A systematic review.Frontiers in global women's health · 2022Review
- Free Access to a Broad Contraceptive Method Mix and Women's Contraceptive Choice: Evidence from Sub-Saharan Africa.Studies in family planning · 2021Article
- Article
- Assessing Effectiveness of Multipurpose Voucher Scheme to Enhance Contraceptive Choices, Equity, and Child Immunization Coverage: Results of an Interventional Study from Pakistan.Journal of multidisciplinary healthcare · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundLow modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims to assess the effectiveness of a free, single-purpose voucher approach in increasing the uptake, use and better targeting of modern contraceptives among women from the lowest two wealth quintiles in rural and urban communities of Punjab province, Pakistan.
methodsA quasi-interventional study with pre- and post-phases was implemented across an intervention (Chakwal) and a control district (Bhakkar) in Punjab province (August 2012-January 2015). To detect a 15% increase in modern contraceptive prevalence rate compared to baseline, 1276 women were enrolled in each arm. Difference-in-Differences (DID) estimates are reported for key variables, and concentration curves and index are described for equity.
resultsCompared to baseline, awareness of contraceptives increased by 30 percentage points among population in the intervention area. Vouchers also resulted in a net increase of 16% points in current contraceptive use and 26% points in modern methods use. The underserved population demonstrated better knowledge and utilized the modern methods more than their affluent counterparts. Intervention area also reported a low method-specific discontinuation (13.7%) and high method-specific switching rates (46.6%) amongst modern contraceptive users during the past 24 months. The concentration index indicated that voucher use was more common among the poor and vouchers seem to reduce the inequality in access to modern methods across wealth quintiles.
conclusionVouchers can substantially expand contraceptive access and choice among the underserved populations. Vouchers are a good financing tool to improve equity, increase access, and quality of services for the underserved thus contributing towards achieving universal health coverage targets.
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