Improving access to reproductive and child health services in developing countries: are competitive voucher schemes an option?

Reducing maternal and child mortality is an important goal of the Millennium declaration and a major concern for policy makers in developing countries. One of the important barriers to reducing maternal mortality is the low utilisation of maternal health services provided by the public health system through it supply side mechanisms. Demand side financing is increasingly being proposed as one of the options to increase access to reproductive and child health services and is generating great interest in a number of developing countries. Demand side financing not only promotes equity through improved access and better targeting of subsidies, but also provides incentives for efficiency and provider choice by involving the private sector. This paper discusses the concept of demand side financing, and analyses its strengths and limitations.