In Lao PDR’s Sekong Province, Over 50 Percent of the Population Get Free Access to Healthcare

Lin, 22, holds her seven-week-old daughter firmly as she wraps a piece of cloth tightly around the baby’s body. She is waiting to meet a health worker about family planning at the Maternal Neonatal and Child Health (MNCH) section of Sekong Provincial Hospital.

In the MNCH consultation room, Lin is reluctant to have her baby vaccinated. Unlike her first born, her young daughter has not received the required immunizations.

“I completed all the doses of required vaccinations [for the first child], but I do not want to repeat taking vaccines for my second child,” she says. “It is very painful and I do not see any need for vaccination. My child is healthy.” It took Somsei Luangphukdee, a health worker, some time to convince Lin about the benefits of having her newborn baby vaccinated.

Sekong province was one of five provinces —targeted by the Ministry of Health and supported by the World Bank to increase usage and quality of health services for poor women and children, particularly in rural areas. The project supported health facilities to effectively deliver to the population quality health care services, including immunization, antenatal care, postnatal care, delivery, nutrition, and family planning services. To address the fact that many poor households in rural areas of Lao PDR do not visit health facilities due to geographical, financial, and cultural barriers, the project also supported outreach sessions that brought health facility staff to deliver basic health, nutrition, and family planning services to the rural communities, as well as to raise awareness and encourage members of the rural communities (particularly pregnant women and caregivers of infants and young children) to visit health facilities for additional maternal and child health and nutrition services.

The Health Services Improvement Project (HSIP) has funded more than 750,000 services that helped poor and vulnerable people gain access to a basic package of health, nutrition, or reproductive health services. To serve these communities, 424 health facilities were constructed and renovated, and more than 3,350 health personnel have received training.

Under the project, a Health Equity Fund (HEF) is helping to provide benefits to households based on their income status; all of the poor in Sekong province are covered by the fund. With support from the project, the Lao PDR Government contracted the Swiss Red Cross (SRC) to provide free basic health services to poor families under HEF—known locally as the poor insurance card.

“Thanks to the World Bank support that put systems in place, it was possible to expand basic health services across Sekong province,” says Vanhnakhone, deputy head of Lamam district.

World Bank support continues under the new Health Governance and Nutrition Development Project to improve coverage of reproductive, maternal, and child health and nutrition services for women and children in the country. Over five years, the project is expected to benefit one million women and children across 14 provinces. In addition, children in higher priority districts will benefit from changed behaviors and practices of their caregivers, as a result of intensive and social behavior change communication campaigns for improved health and nutrition.

Sekong is also one of the 14 provinces under the new project to receive continued support on family planning, improving the availability and quality of maternal and child health and nutrition services, and strengthening health systems.

Through the project’s outreach sessions, mothers like Monemany, 32, have become aware of the importance of child and maternal health care and nutrition.

“Going to a health center is all about me and my child’s life and future—it does not matter if I receive an incentive or not,” says Monemany.

Nom, 22, from Paktone village, has noticed the improvements in skills and attitude of health care staff since the delivery of her first child in 2012.

“I delivered all my children in the hospital,” says the mother of three. “I have witnessed a lot of change in overall quality of health services in Sekong Hospital. There are more facilities for patients, and nurses and doctors are more receptive.”