Kimberly Smith, MPA¹, Caroline Quijada, MHS¹, and Tania Dmytraczenko, PhD². (1) Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-718-3185, kimberly_smith@abtassoc.com, (2) Abt Associates Inc, Suite 600, 4800 Montgomery Lane, Bethesda, MD 20814

Community-based health financing (CBHF) schemes have been proposed as one way of reducing economic barriers to care, and, in doing so, increasing utilization of priority health services. In addition, proponents argue that CBHF schemes have the potential to increase utilization through scheme-organized health promotion activities and social interactions among members. Impact evaluations of schemes in Rwanda, Senegal, and Tanzania support the argument that CBHF can be a valuable tool for increasing use of health services covered by these schemes. However, there is considerable variation in the types of priority services included in the benefits packages of CBHF schemes. Most schemes in Sub-Saharan Africa cover maternal health services, including antenatal care, basic deliveries, and some level of obstetric care. On the other hand, many schemes do not cover reproductive health services and commodities. Against this background, this study uses qualitative and quantitative research methods to examine the actual and potential role of CBHF schemes in Senegal, known as mutual health organizations, in increasing access to and utilization of reproductive health services and commodities. The qualitative component uses focus groups and in-depth interviews to (1) gain insight into the decision-making process leading to benefits selection and (2) to identify MHO-related factors that explain differences in member vs. non-member utilization among different MHO target populations in the Thies and Louga regions of Senegal. The quantitative component includes an analysis of utilization data from a survey of MHO member and non-member households. The study results will be used to promote the inclusion of reproductive health services in the benefits packages of CBHF schemes.

Learning Objectives: At the end of this session, participants will be able to

• Understand the purpose, design, and functioning of community-based health financing schemes (CBHF) within the context of reproductive health promotion;
• Explain the decision-making process of different types of CBHF schemes in Senegal leading to selection of a defined benefits package;
• Identify the specific factors that influence the decision to include or exclude reproductive health services from the benefits packages of CBHF schemes; and
• Explain the environmental, organizational, and other factors that affect the impact of CBHF schemes on utilization of reproductive health services and commodies.

Keywords: Reproductive Health, Financing

Related Web page: www.phrproject.com

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: USAID-financed Partners for Health Reform plus (PHRplus) project
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.