Credit: Options/NHSSP

Equitable services

Equity, inclusivity and gender equality are central to our programmes.  We work to reduce the barriers that prevent access to services by identifying and understanding the different types of barriers, who is affected and how best we can make sustainable improvements within the context of each programme.

We work directly to strengthen health systems and support efforts to achieve universal health coverage but also take a transformative approach where possible, working with multiple partners and in multi-disciplinary teams.  This is strengthened by sharing expertise and lessons learned across our programmes.

We work to make health services more equitable 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 and for the people with greatest need.
  • Supporting the design of health service models that are responsive to these needs and demands.
  • Developing systems of accountability so that communities, women and other vulnerable and often marginalised groups can effectively demand better-quality services.
  • Reducing financial barriers through results-based financing approaches that increase the use and accessibility of services for vulnerable or previously ‘left behind’ groups, and generate investment for better-quality health services.
  • Strengthening health systems to deliver more equitable health services through responsive planning, budgeting and management informed by health information systems that provide evidence of equity gaps.
  • Supporting governments to develop policies and strategies in pursuit of universal coverage and equity.

In Kenya, the Maternal and Newborn Improvement (MANI) project is implementing a voucher programme in Bungoma County that entitles poor pregnant women to free transport to and from their nearest facility, to access quality maternal and newborn health services.   As of November 2016 MANI has distributed 11,342 vouchers. More than 2,000 community health volunteers are responsible for distributing vouchers to the poorest women and providing them with basic health information in the lead up to delivery. 

In Nepal, we are improving access to services for women living in remote areas, where families often live several days’ travel from their closest health facility. We are supporting the design and piloting of equity monitoring of health services. We have helped establish one-stop crisis management centres (OCMC) providing services to survivors of gender-based violence. Through our advisers embedded in the Ministry of Health we are supporting the government to develop gender and socially inclusive policies, build staff awareness and integrate gender and social inclusion into planning and budgeting. We are strengthening the health management information system to provide disaggregated data and track inequities, and piloting Social Service Units that provide subsidies for vulnerable groups at tertiary hospitals.

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.  Village Health Committees actively involve women in making decisions about ways in which health services can be improved. They also identify vulnerable groups in the communities and come up with local solutions to make sure these groups are able to access services.

In India, we have supported the Government of Odisha to improve access to health, nutrition, water and sanitation services in underserved areas; strengthening of public health management systems; health care seeking behaviour change communication; and use of evidence in planning and delivery. We carried out India’s first household level survey looking at health, nutrition and WASH behaviour at the household, block, district and state level. The data collected highlighted gaps and informed local and state level decisions to improve equitable access to services.

In Malawi, our health sector programme (MHSP) is revitalising, training and mentoring Health Centre Advisory Committees (HCAC) including incorporating drug monitoring into HCAC activities.  We are increasing representation of women and other vulnerable/marginalised groups such as people with disabilities, youth and hard to reach communities on HCACs.  Alongside this, and linking facility- with district-level accountability and governance structures, MHSP has trained members of District Councils’ Health and Environment Committees on their oversight responsibilities and helped district councillors tackle gender and disability issues.

Results

MANI has distributed 11,342 vouchers to poor mothers to enable them access to quality MNH services

In Nepal 21 OCMCs have been established and strengthened in hospitals

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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