Credit: Options/NHSSP

Accessing services

The health of women is key to promoting healthy populations and the economic development of a nation. Yet there are many barriers to women accessing the health services they need – lack of access to financial resources, cultural barriers, a lack of understanding of the importance of maternal health care on the part of extended family members, or simply living too far away from services. These barriers result in high rates of maternal and child deaths, high fertility and persistent gender inequality.

We work to make health services more accessible by:

  • Conducting and sharing research of people’s health needs and preferences so that planners and decision-makers have the evidence they need to plan services in the places where they are most needed
  • Supporting the design of health service models that are responsive to these needs and demands
  • Developing systems of accountability so that communities and women can effectively demand better-quality services
  • Reducing financial barriers through results-based financing (RBF) approaches that increase the use and accessibility of services and generate investment for better-quality health services.

In Nepal, we are working to improve access to services for women living in remote areas where families often live several days’ travel from their closest health facility. We are working with the Government of Nepal to pilot a package of interventions that improve access to and the use of maternal and neonatal health services in a remote, mountainous district in Eastern Nepal.

In Nigeria, we are supporting facilities and government staff to use data in planning services that respond to local needs. We are helping communities and civil society groups to access information on health services – and demand better, high quality services, when and where they are needed.

In Malawi, we use RBF to improve access to maternity care. We do this by providing performance-based financial incentives to health facilities and district health management teams for delivery of high-quality care. We provide vouchers for health care, and small cash transfers to women to cover the costs of travel to and from the facility. The cash transfer is given once a woman remains in the facility for three days post-delivery, and in doing so, increases newborn survival rates.

In the UK, we were commissioned by Gateshead primary care trust (PCT) to design a sexual health service that meant people could be seen within 48 hours. Our team worked with health service commissioners and the sexual health team within Gateshead PCT to design and carry out consultations and to co-design methods best suited to the local population. The result of this was a one-stop shop walk-in health centre that offered on-site contraception and sexual health testing and treatment – all within an hour.

Quick Facts

In Nepal the percentage of births attended by a skilled birth attendant has increased from 37% in 2012 to 55% in 2014

60,903 women have delivered safely in an RBF facility in Malawi since 2012

HIV testing of pregnant women increased in RBF facilities in Malawi from 23% at baseline to 82% by 2014

At Gateshead in the UK more than 2,000 new patients used sexual health services in one year

Our experts

  • Matthew Nviiri
    Matthew Nviiri is a public health specialist who has spent the past decade working on results- and performance-based financing projects. He has designed RBF country strategies for Uganda and Rwanda. He is currently Project Director of our Maternal and Newborn Health Initiative, improving maternal and newborn health outcomes using innovative financing mechanisms. While in Uganda, Matthew worked closely with the Ministry of Health and played an important role in the implementation of the national health strategies.
  • Rachel Grellier
    Rachel Grellier is a senior gender and social inclusion specialist with extensive experience in the areas of maternal health, sexual and reproductive health, HIV/AIDS, gender, and voice and accountability. Rachel has led evaluation and impact assessments, and is experienced in using a wide variety of approaches to gain insights into patients’, communities’, service providers’ and governments’ perspectives on health programmes. She is a PEER (Participatory Ethnographic Evaluation and Research) specialist, having led and supervised studies in Zambia, Kenya, Tanzania, Morocco, Uganda, Rwanda, Papua New Guinea and India.
  • Dr Maureen Dar Iang
    Dr Maureen Dar Iang has over 20 years experience in the planning and delivery of maternal and newborn, reproductive and child health programmes. She has played a key role in strengthening district health systems in Nepal, building capacity of service providers, and supporting national policy discussions on safe motherhood and family planning. She is coordinating our support to recovery of essential health care services in earthquake affected districts.
  • Corinne Grainger
    Corinne Grainger has over 20 years’ experience as a consultant providing technical assistance to reproductive, maternal and newborn health programmes. Corinne is a health financing specialist with expertise in results based financing approaches to increase access to quality health services. She has supported design of RBF and voucher programmes in Malawi, Yemen, Pakistan and Mozambique.
  • Deborah Thomas
    Deborah is a senior gender and social inclusion specialist with over 20 years’ experience in the health sector. She has worked on a wide range of health programmes at the national, sub-national, district and local levels, including maternal, new-born and child health programmes, reproductive and sexual health, and health sector reform programmes. Deborah has extensive experience in South Asia, and has also worked in South-East Asia, China, the Pacific, West and East Africa.

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More about Options
Established in 1992, Options has worked in over 50 countries. We lead and manage health sector programmes on behalf of international donors and national governments.
Established in 1992, Options has worked in over 50 countries. We lead and manage health sector programmes on behalf of international donors and national governments.

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