Impact of a Voucher Program on Reproductive Health Care for Adolescents in Nicaragua
Author Information
Author(s): Liesbeth E. Meuwissen, Anna C. Gorter, Arnold D.M. Kester, J. Andre Knottnerus
Primary Institution: Instituto CentroAmericano de Salud (ICAS)
Hypothesis
Does a competitive voucher program for adolescents improve the quality of reproductive health care?
Conclusion
The voucher program improved access to contraceptives and quality of care for adolescents, particularly in clinics with the weakest initial performance.
Supporting Evidence
- The voucher program led to a significant increase in the number of adolescents leaving clinics with contraceptive methods.
- Shared decision-making between doctors and patients improved during the program.
- Condom promotion increased significantly after the intervention.
Takeaway
The study shows that giving vouchers to teenagers helped them get better access to birth control and made doctors more helpful.
Methodology
The study used simulated patients to evaluate the quality of reproductive health care before, during, and after the voucher program.
Potential Biases
Some clinics may have favored voucher users over non-voucher users.
Limitations
The improvements in care quality did not sustain after the program ended.
Participant Demographics
Adolescents aged 12 to 20, primarily female, from disadvantaged areas.
Statistical Information
P-Value
p = 0.01
Confidence Interval
95% CI 2.5 – 3.9
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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