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BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: A qualitative evaluation

Authors: Rebecca Njuki, Jerry Okal, Charlotte E Warren, Francis Obare, Timothy Abuya, Lucy Kanya, Chi-Chi Undie, Ben Bellows, Ian Askew

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Few studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services.

Methods

A qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya.

Results

The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services.

Conclusions

The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers.
Appendix
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Literature
1.
Finkelhor D: The international epidemiology of child sexual abuse. Child Abuse Negl. 1994, 18: 409-417. 10.1016/0145-2134(94)90026-4.CrossRefPubMed
2.
Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts CH: Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Lancet. 2006, 368: 1260-1269. 10.1016/S0140-6736(06)69523-8.CrossRefPubMed
3.
Hindin MJ, Kishor S, Ansara DL: Intimate Partner Violence among Couples in 10 DHS Countries: Predictors and Health Outcomes. DHS Analytical Studies No. 18. 2008, Macro International Inc, Calverton, Maryland, USA
4.
Muhajarine N, D'Arcy C: Physical abuse during pregnancy: prevalence and risk factors. Canadian Med Assoc J. 1999, 160: 1007-1011.
5.
Kishor S, Johnson K: Profiling Domestic Violence – A Multi-Country Study. 2004, ORC Macro, Calverton, Maryland
6.
Jewkes R, Levin J, Penn-Kekana L: Risk factors for domestic violence: findings from a South African cross-sectional study. Soc Sci Med. 2002, 55: 1603-1617. 10.1016/S0277-9536(01)00294-5.CrossRefPubMed
7.
Koenig MA, Lutalo T, Zhao F, Nalugoda F, Wabwire-Mangen F, Kiwanuka N, Wagman J, Serwadda D, Wawer M, Gray R: Domestic violence in rural Uganda: evidence from a community-based study. Bull World Health Org. 2003, 81: 53-60.PubMedPubMedCentral
8.
Watts C, Zimmerman C: Violence against women: global scope and magnitude. Lancet. 2002, 359: 1232-1237. 10.1016/S0140-6736(02)08221-1.CrossRefPubMed
9.
Kenya National Bureau of Statistics (KNBS): ICF Macro: Kenya Demographic and Health Survey 2008–09. 2010, KNBS and ICF Macro Calverton, Maryland
10.
Åsling-Monemi K, Naved RT, Persson LÅ: Violence against women and the risk of under-five mortality: analysis of community-based data from rural Bangladesh. Acta Paediat. 2008, 97: 226-232. 10.1111/j.1651-2227.2007.00597.x.CrossRefPubMed
11.
Fischbach RL, Herbert B: Domestic violence and mental health: correlates and conundrums within and across cultures. Soc Sci Med. 1997, 45: 1161-1176. 10.1016/S0277-9536(97)00022-1.CrossRefPubMed
12.
Heise L, Ellsberg M, Gottmoeller M: A global overview of gender-based violence. Int J Gyn Obstet. 2002, 78 (Suppl 1): S5-S14.CrossRef
13.
Bott S, Morrison A, Ellsberg M: Preventing and responding to Gender-based violence in middle and low-income countries: A global review and analysis. 2005, World Bank, Washington, DCCrossRef
14.
Emenike E, Lawoko S, Dalal K: Intimate partner violence and reproductive health of women in Kenya. Int Nurse Rev. 2008, 55: 97-102. 10.1111/j.1466-7657.2007.00580.x.CrossRef
15.
Garcia-Moreno C, Watts C: Violence against women: its importance for HIV/AIDS. AIDS. 2000, 14 (Suppl 3): S253-S265.PubMed
16.
Reppucci ND, Woolard JL, Fried CS: Social, community, and preventive interventions. Annual Rev Psych. 1999, 50: 387-418. 10.1146/annurev.psych.50.1.387.CrossRef
17.
Türmen T: Gender and HIV/AIDS. Int J Gyn Obstet. 2003, 82: 411-418. 10.1016/S0020-7292(03)00202-9.CrossRef
18.
Letourneau EJ, Holmes M, Chasedunn-Roark J: Gynecologic health consequences to victims of interpersonal violence. Womens Health Issues. 1999, 9: 115-120. 10.1016/S1049-3867(98)00031-0.CrossRefPubMed
19.
Maman S, Campbell J, Sweat MD, Gielen AC: The intersections of HIV and violence: directions for future research and interventions. Soc Sci Med. 2000, 50: 459-478. 10.1016/S0277-9536(99)00270-1.CrossRefPubMed
20.
Janisch CP, Albrecht M, Wolfschuetz A, Kundu F, Klein S: Vouchers for health: A demand side output-based aid approach to reproductive health services in Kenya. Global Pub Health. 2010, 5: 578-594. 10.1080/17441690903436573.CrossRef
21.
Bhatia MR, Gorter AC: Improving access to Reproductive and Child Health services in developing countries: are competitive voucher schemes an option?. J Int Dev. 2007, 19: 975-981. 10.1002/jid.1361.CrossRef
22.
Schmidt JO, Ensor T, Hossain A, Khan S: Vouchers as demand side financing instruments for health care: a review of the Bangladesh maternal voucher scheme. Health Pol. 2011, 96: 98-107.CrossRef
23.
Richard F, Witter S, de Brouwere V: Innovative approaches to reducing financial barriers to obstetric care in low-income countries. Am J Pub Health. 2010, 100: 1845-1852. 10.2105/AJPH.2009.179689.CrossRef
24.
Prata N, Sreenivas A, Greig F, Walsh J, Potts M: Setting priorities for safe motherhood interventions in resource-scarce settings. Health Pol. 2010, 94: 1-13. 10.1016/j.healthpol.2009.08.012.CrossRef
25.
Steuerle C: Common issues for voucher programs. Vouchers and the provision of public services. Edited by: Steuerle C, Oooms V, Ptereson G, Reischauer R. 2000, The Brookings Institution, Washington, DC, 1-37.
26.
Schellenberg JA, Victora CG, Mushi A, de Savigny D, Schellenberg D, Mshinda H, Bryce J: Inequities among the very poor: health care for children in rural southern Tanzania. Lancet. 2003, 361: 561-566. 10.1016/S0140-6736(03)12515-9.CrossRefPubMed
27.
Ir P, Horemans D, Souk N, van Damme W: Using targeted vouchers and health equity funds to improve access to skilled birth attendants for poor women: a case study in three rural health districts in Cambodia. BMC Preg Childbirth. 2010, 10: 1-10.1186/1471-2393-10-1.CrossRef
28.
Meuwissen LE, Gorter AC, Kester ADM, Knottnerus JA: Does a competitive voucher program for adolescents improve the quality of reproductive health care?, A simulated patient study in Nicaragua. BMC Pub Health. 2006, 6: 204-10.1186/1471-2458-6-204.CrossRef
29.
Bellows NM, Bellows BW, Warren C: Systematic Review: the use of vouchers for reproductive health services in developing countries: systematic review. Trop Med Int Health. 2011, 16: 84-96. 10.1111/j.1365-3156.2010.02667.x.CrossRefPubMed
30.
Obare F, Warren C, Njuki R, Abuya T, Sunday J, Askew I, Bellows B: Community-level impact of the reproductive health vouchers programme on service utilization in Kenya. Health Pol Plan. 2012
31.
Bellows B, Kyobutungi C, Mutua MK, Warren C, Ezeh A: Increase in facility-based deliveries associated with a maternal health voucher programme in informal settlements in Nairobi, Kenya. Health Pol Plan. 2012
32.
Warren C, Abuya T, Obare F, Sunday S, Njuki N, Askew I, Bellows B: Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya. BMC Pub Health. 2011, 11: 177-10.1186/1471-2458-11-177.CrossRef
33.
McCannon CJ, Berwick DM, Massoud MR: The science of large-scale change in global health. JAMA. 2007, 298: 1937-1939. 10.1001/jama.298.16.1937.CrossRefPubMed
34.
Renju J, Makokha M, Kato C, Medard L, Andrew B, Remes P, Changalucha J, Obasi A: Partnering to proceed: scaling up adolescent sexual reproductive health programmes in Tanzania, Operational research into the factors that influenced local government uptake and implementation. Health Res Policy Syst. 2010, 8: 12-10.1186/1478-4505-8-12.CrossRefPubMedPubMedCentral
35.
Lisa V, Haffejee S: Factors affecting adherence to post-exposure prophylaxis in the aftermath of sexual assault: key findings from seven sites in Gauteng Province. 2005, Centre for the Study of Violence and Reconciliation, Cape Town
36.
Jewkes R: Intimate partner violence: causes and prevention. Lancet. 2002, 359: 1423-1429. 10.1016/S0140-6736(02)08357-5.CrossRefPubMed
37.
Ministry of Public Health and Sanitation (MOPHS) [Kenya]: Ministry of Medical Services (MOMS) [Kenya]. National Guidelines on Management of Sexual Violence in Kenya. 2009, MOPHS & MOMS, Nairobi
Metadata
Title
Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: A qualitative evaluation
Authors
Rebecca Njuki
Jerry Okal
Charlotte E Warren
Francis Obare
Timothy Abuya
Lucy Kanya
Chi-Chi Undie
Ben Bellows
Ian Askew
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-426

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