Targeting accuracy and impact of a community-identified waiver card scheme for primary care user fees in Afghanistan

User fees are a known common barrier to using health services, particularly among the poor. When fees are present, many facilities have waiver systems for poor patients to exempt them from paying. Targeting waivers to patients who need them most has been a challenge, especially in fragile states, where relevant data are limited and trust in institutions is low. An analysis of the asset index of beneficiaries indicated that although targeting was progressive, significant leakage and high levels of under-coverage occurred; 42% of cards were used by people in the wealthiest three quintiles, and only 19% of people in the poorest quintile received a card. Households with waiver cards reported higher rates of care-seeking for recent illnesses compared to those without cards (p = 0.02).

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WP15 - Nutritional Status of Children in India: Household Socio-Economic Condition as the Contextual Determinant

Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socioeconomic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.

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WP14 - Revisiting the Role of Geographical Accessibility in Women's Access to Healthcare

The objectives of this working papers are studying the differentials of health service availability and uptake of services particularly for women's health needs related to out-patient care and institutional childbirth. Understanding their various predictors, along with the issues related to geographical accessibility, in the context of the Sundarbans.

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WP13 - Engaging the private sector in maternal and neonatal health in low and middle income countries

We reviewed existing literature on private sector initiatives that have shown effectiveness in improving maternal and neonatal health. The private sector constitutes a significant proportion of delivery services for women in developing countries and it also plays a key role in family planning, abortion, nutrition, and antenatal care. We primarily address maternal health outcomes and include interventions that improve neonatal health outcomes where they are included in the study design or interventional strategy alongside maternal outcomes. We do not review evidence that addresses neonatal outcomes alone, as this would go beyond the scope of this paper.

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Infant and under-five mortality in Afghanistan: current estimates and limitations

The objective of this article is to examine historical estimates of infant and under-five mortality in Afghanistan, provide estimates for rural areas from current population-based data, and discuss the methodological challenges that undermine data quality and hinder retrospective estimations of mortality.

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