Assessing the Voucher System in Madagascar

ThinkWell worked closely with the Project Implementation Unit of the Ministry of Public Health in Madagascar to understand the complexities of a maternal and child voucher system currently being piloted in 18 of Madagascar’s 122 districts. ThinkWell’s work included developing a detailed understanding of the current system of health financing in Madagascar, conducting field visits to observe the voucher system as it functions on the ground, and meeting with administrators and beneficiaries of the system.

ThinkWell identified strengths of the current system as well as bottlenecks to improved functioning. In addition, the ThinkWell team suggested ways of increasing use of the services offered through the voucher by reinforcing incentives for pregnant women and parents of children under five years of age. Finally, ThinkWell developed proposals to integrate the voucher system into Madagascar’s health financing scheme, with recommendations to ensure that all health financing mechanisms operate symbiotically and within the available national resource envelope.

Photo credit: (c) 2008 Cory Plowman, courtesy of Photoshare

Photo credit: (c) 2008 Cory Plowman, courtesy of Photoshare

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