Ashish Bajracharya

Microcredit and domestic violence in Bangladesh: an exploration of selection bias influences

This article explores the relationship between women’s participation in microcredit groups and domestic violence in Bangladesh. Several recent studies have raised concern about microcredit programs by reporting higher levels of violence among women who are members. These results, however, may be attributable to selection bias because members might differ from nonmembers in ways that make them more susceptible to violence to begin with. Using a sample of currently married women from the 2007 Bangladesh Demographic Health Survey (BDHS) (N = 4,195), we use propensity score matching (PSM) as a way of exploring selection bias in this relationship. Results suggest that the previously seen strong positive association between membership and violence does not hold when an appropriate comparison group, generated using PSM, is used in the analyses. Additional analyses also suggest that levels of violence do not differ significantly between members and nonmembers and instead could depend on context-specific factors related to poverty. Members for whom a match is not found report considerably higher levels of violence relative to nonmembers in the unmatched group. The background characteristics of members and nonmembers who do not match suggest that they are more likely to be younger and from relatively well-to-do households.

Distance, Transportation Cost, and Mode of Transport in the Utilization of Facility-Based Maternity Services: Evidence from Rural Bangladesh

Although the maternal mortality ratio in Bangladesh has decreased, significant underutilization of facilities continues to be a persistent challenge to policy makers. Women face long distances and significant transportation cost to deliver at health facilities. This study identifies the distance traveled to utilize facilities, associated transportation cost, and transport mode used for maternal healthcare services. A total of 3,300 mothers aged 18–49 years, who had given birth in the year before the survey, were interviewed from 22 sub-districts in 2010. Findings suggest that facility-based maternal healthcare service utilization was very poor. Only 53% of women received antenatal care, 20% used delivery care. and 10% used postnatal care from health centers. Median distance traveled for antenatal and postnatal check-ups was 2 kilometers but 4 kilometers for complication management care and delivery. Most women used non-motorized rickshaw or van to reach a health facility. On average, women spent Taka 100 (US

Family Planning Vouchers in Low and Middle Income Countries: A Systematic Review

1.40) as transportation cost for antenatal care, Taka 432 (US

Increasing Uptake of Long-Acting Reversible Contraceptives in Cambodia Through a Voucher Program: Evidence From a Difference-in-Differences Analysis

6.17) for delivery, and Taka 132 (US

Evaluation of a voucher programme in reducing inequities in maternal health utilisation in Cambodia: a quasi-experimental study

1.89) for postnatal check-up. For each additional kilometer, the cost increased by Taka 9 (US

Relationship between self-efficacy and HIV testing uptake among young men who have sex with men in Myanmar: a cross-sectional analysis

0.13) for antenatal, Taka 31 (US

Making free public healthcare attractive: optimizing health equity funds in Cambodia

0.44) for delivery, and Taka 8 (US

Factors associated with HIV testing among young men who have sex with men in Myanmar : a cross-sectional study

0.11) for postnatal care.

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and status in Cambodia

Family planning (FP) vouchers have targeted subsidies to disadvantaged populations for quality reproductive health services since the 1960s. To summarize the effect of FP voucher programs in low‐ and middle‐income countries, a systematic review was conducted, screening studies from 33 databases through three phases: keyword search, title and abstract review, and full text review. Sixteen articles were selected including randomized control trials, controlled before‐and‐after, interrupted time series analyses, cohort, and before‐and‐after studies. Twenty‐three study outcomes were clustered around contraceptive uptake, with study outcomes including fertility in the early studies and equity and discontinuation in more recent publications. Research gaps include measures of FP quality, unintended outcomes, clients’ qualitative experiences, FP voucher integration with health systems, and issues related to scale‐up of the voucher approach.

Poverty, Marriage Timing, and Transitions to Adulthood in Nepal

By reducing financial and information barriers, a family planning voucher program in Cambodia significantly increased contraceptive choice and uptake of more effective long-acting reversible contraceptives among poor women and women with the least education. Without vouchers, many of these women would not have used contraception or would not have chosen their preferred method. By reducing financial and information barriers, a family planning voucher program in Cambodia significantly increased contraceptive choice and uptake of more effective long-acting reversible contraceptives among poor women and women with the least education. Without vouchers, many of these women would not have used contraception or would not have chosen their preferred method. ABSTRACT Objective: This article evaluates the use of modern contraceptives among poor women exposed to a family planning voucher program in Cambodia, with a particular focus on the uptake of long-acting reversible contraceptives (LARCs). Methods: We used a quasi-experimental study design and data from before-and-after intervention cross-sectional household surveys (conducted in 2011 and 2013) in 9 voucher program districts in Kampong Thom, Kampot, and Prey Veng provinces, as well as 9 comparison districts in neighboring provinces, to evaluate changes in use of modern contraceptives and particularly LARCs in the 12 months preceding each survey. Survey participants in the analytical sample were currently married, non-pregnant women ages 18 to 45 years (N = 1,936 at baseline; N = 1,986 at endline). Difference-in-differences (DID) analyses were used to examine the impact of the family planning voucher. Results: Modern contraceptive use increased in both intervention and control areas between baseline and endline: in intervention areas, from 22.4% to 31.6%, and in control areas, from 25.2% to 31.0%. LARC use also increased significantly between baseline and endline in both intervention (from 1.4% to 6.7%) and control (from 1.9% to 3.5%) areas, but the increase in LARC use was 3.7 percentage points greater in the intervention area than in the control area (P = .002), suggesting a positive and significant association of the voucher program with LARC use. The greatest increases occurred among the poorest and least educated women. Conclusion: A family planning voucher program can increase access to and use of more effective long-acting methods among the poor by reducing financial and information barriers.