A guide to competitive vouchers in health

This World Bank guide examines voucher schemes as a means of subsidising healthcare goods and services for the poor. It focuses on schemes that involve some form of competition between service providers, which provide the recipient with choices and which involve the private sector. It does not examine voucher schemes where vouchers can be exchanged for cash as an incentive to use health services.

The guide discusses the reasons why policymakers would choose a voucher system, and the advantages and disadvantages of it. The former include the fact that compared to other demand-side health subsidies vouchers can be more effectively targeted and so the subsidy can reach a higher proportion of its intended recipients. One of the disadvantages is the higher level of administrative costs. The guide provides a step-by-step analysis of the different stages involved in the introduction of a voucher scheme. The preliminary stages involve conducting feasibility studies, costing the scheme and building partnerships. This is followed by the design and implementation stages. The guide also includes information on putting in place monitoring and evaluation systems for the scheme.