Utilization and management of maternal and child health funds in rural Nepal


Morrison, J; Thapa, R; Sen, A; Neupane, R; Borghi, J; Tumbahangphe, KM; Osrin, D; Manandhar, D; Costello, A; (2010) Utilization and management of maternal and child health funds in rural Nepal. Community development journal, 45 (1). pp. 75-89. ISSN 0010-3802 DOI: https://doi.org/10.1093/cdj/bsn029

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Abstract

Maternal and neonatal mortality rates are highest in the poorest countries, and financial barriers impede access to health care. Community loan funds can increase access to cash in rural areas, thereby reducing delays in care seeking. As part of a participatory intervention in rural Nepal, community women's groups initiated and managed local funds. We explore the factors affecting utilization and management of these funds and the role of the funds in the success of the women's group intervention. We conducted a qualitative study using focus group discussions, group interviews and unstructured observations. Funds may increase access to care for members of trusted 'insider' families adjudged as able to repay loans. Sustainability and sufficiency of funds was a concern but funds increased women's independence and enabled timely care seeking. Conversely, the perceived necessity to contribute may have deterred poorer women. While funds were integral to group success and increased women's autonomy, they may not be the most effective way of supporting the poorest, as the risk pool is too small to allow for repayment default.

Item Type: Article
Keywords: COMMUNITY LOAN FUNDS, OBSTETRIC EMERGENCIES, NEWBORN BABIES, CARE, MORTALITY, TRANSPORT, SERVICES, NIGERIA, BANGLADESH, AFRICA
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Web of Science ID: 289303700006
URI: http://researchonline.lshtm.ac.uk/id/eprint/831

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