Spillover effects of demand side financing projects on health care utilization in Afghanistan

Abstract

Based on Demand Side Financing programs in Afghanistan in 2009-2011, this study aims to assess the spillover effects of programs in the areas other than targeted areas of institutional delivery and vaccination. Socio economic factors associated with general health care utilization among 6677 women who were older than 18 years old in Afghanistan are explored. The ordered probit model is used for analyzing the relationship between cash incentives, socio economic factors and health care utilization (including self and family utilization). The Demand Side Financing programs end-line survey data set in 2011 is used for analyzing. According to the main findings of this study relationship between the cash incentive programs and health care utilization is positive at 5% significant level. The rationale behind this relationship might be due to relaxation of family income constrains as transportation cost was covered as well as the positive relationship could be due to referral effort by Community Health Worker who received cash incentive from the program too. Women’s education has a positive relationship with health care utilization, along with some other education program like reproductive health and family planning health education programs. Cash incentives are recommended to increase health care utilization at formal facilities and to improve the referral system especially at the primary health care level.