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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