Jhpiego - an affiliate of Johns Hopkins University, New Delhi, 110020, India.
BMC Health Serv Res. 2021 Sep 3;21(1):905. doi: 10.1186/s12913-021-06799-1.
In an effort to encourage Family Planning (FP) adoption, since 1952, the Government of India has been implementing various centrally sponsored schemes that offer financial incentives (FIs) to acceptors as well as service providers, for services related to certain FP methods. However, understanding of the role of FIs on uptake of FP services, and the quality of FP services provided, is limited and mixed.
A qualitative descriptive study was conducted in Chatra and Palamu districts of Jharkhand state. A total of 64 interviews involving multiple stakeholders were conducted. The stakeholders included recent FP acceptors or clients, FP service providers of public health facilities including Accredited Social Healthcare Activists (ASHAs), government health officials managing FP programs at the district and state level, and members of development partners supporting FP programs in Jharkhand. Data analysis included both inductive and deductive strategies. It was done using the software Atlas ti version 8.
It has emerged that there is a strong felt need for FP among majority of the clients, and FIs may be a motivator for uptake of FP methods only among those belonging to the lower socio economic strata. For ASHAs, FI is the primary motivator for providing FP related services. There may be a tendency among them and the nurses to promote methods which have more financial incentives linked with them. There are mixed opinions on discontinuing FIs for clients or replacing them with non-financial incentives. Delays in payment of FIs to both clients and the ASHAs is a common issue and adversely effects the program.
FIs for clients have limited influence on their decision to take up a FP method while different amounts of FIs for ASHAs and nurses, linked with different FP methods, may be influencing their service provision. More research is needed to determine the effect of discontinuing FI for FP services.
为鼓励计划生育（FP）的推广，自 1952 年以来，印度政府一直在实施各种中央资助计划，为接受者和服务提供者提供与某些 FP 方法相关的服务提供财务激励（FI）。然而，对于 FI 对 FP 服务的采用和提供的 FP 服务的质量的作用的理解是有限的和混杂的。
在恰蒂斯加尔邦和帕尔马姆地区的恰蒂斯加尔邦进行了一项定性描述性研究。总共进行了 64 次涉及多个利益相关者的访谈。利益相关者包括最近的 FP 接受者或客户、公共卫生设施的 FP 服务提供者，包括认可的社会医疗保健活动家（ASHAs）、管理地区和州一级 FP 计划的政府卫生官员，以及支持在恰蒂斯加尔邦的 FP 计划的发展伙伴的成员。数据分析包括归纳和演绎策略。它是使用 Atlas ti 版本 8 软件完成的。
结果表明，大多数客户强烈需要 FP，FI 可能只是那些属于较低社会经济阶层的人采用 FP 方法的动机。对于 ASHAs，FI 是提供 FP 相关服务的主要动机。他们和护士可能有一种倾向，即促进与他们有更多财务激励措施相关的方法。关于停止向客户或用非财务激励措施取代 FI 的意见不一。延迟向客户和 ASHAs 支付 FI 是一个常见的问题，并对计划产生不利影响。
FI 对客户选择采用 FP 方法的决定的影响有限，而不同数量的 FI 与不同的 FP 方法相关联，可能会影响他们的服务提供。需要进行更多的研究来确定停止 FP 服务 FI 的影响。
