This study aimed to assess completeness of antenatal care coverage following implementation of a voucher scheme for maternal health in Bangladesh. The investigation used interview data from a survey conducted in Bangladesh in 2017 of 2400 randomly selected women aged 15–49 with children aged 0–23 months in four geographical areas where voucher scheme implementation was underway. Of these women, 1944 had attended at least one antenatal clinic visit so were included in the analysis. A ‘completeness index’ for antenatal visits was constructed as an outcome variable based on recall of thirteen elements of care. Bivariate analysis against independent variables of interest was carried out and multivariate linear regression models developed to examine the influence of voucher scheme participation on completeness of antenatal care adjusting for socio-demographic characteristics. Voucher scheme membership was associated with higher ‘completeness index’ scores, with a mean score of 185.2±101.0 for voucher recipients and 139.6 ± 93.3 for non-recipients (p<0.001). Scheme membership reduced the differentials associated with health facility type and socioeconomic status. Women from the lowest socioeconomic group who were voucher recipients received substantially more components of antenatal care (mean score: 159.6±82.1) compared with non-recipients (mean score: 115.7±83.0). This favourable effect of voucher scheme membership on the most vulnerable socioeconomic group remained significant after adjusting for educational status. The Bangladesh voucher scheme model has the potential to maximize gains in maternal and newborn health through enhancing the completeness of service provision.

中文翻译：

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孟加拉国孕产妇保健券计划：对产前保健提供完整性的影响

本研究旨在评估孟加拉国实施孕产妇保健代金券计划后产前保健覆盖的完整性。该调查使用了 2017 年在孟加拉国进行的一项调查的访谈数据，该调查在四个正在实施代金券计划的地理区域随机抽取了 2400 名 15-49 岁的女性和 0-23 个月的孩子。在这些妇女中，1944 人至少参加过一次产前门诊就诊，因此被纳入分析。产前检查的“完整性指数”被构建为基于对十三个护理要素的回忆的结果变量。对感兴趣的自变量进行了双变量分析，并开发了多变量线性回归模型，以检查代金券计划参与对调整社会人口特征的产前保健完整性的影响。代金券计划会员资格与较高的“完整性指数”得分相关，代金券接受者的平均得分为 185.2±101.0，非接受者的平均得分为 139.6±93.3（p<0.001)。计划成员减少了与卫生设施类型和社会经济地位相关的差异。与非接受者（平均分：115.7±83.0）相比，接受代金券的最低社会经济群体的妇女接受了更多的产前护理（平均分：159.6±82.1）。在调整教育状况后，代金券计划成员资格对最脆弱的社会经济群体的这种有利影响仍然显着。孟加拉国代金券计划模式有可能通过提高服务提供的完整性来最大限度地提高孕产妇和新生儿健康的收益。