The Influence of Social Health Protection Mechanisms and Community Level Factors on Facility Delivery and Antenatal Care Use in Cambodia: A Multilevel Modeling Approach

In Cambodia, recent figures have shown impressive declines in the maternal mortality rate alongside commensurate increases in maternal healthcare use over the last decade (DHS 2010). In this paper, we examine the determinants of this rise in service use in Cambodia, particularly focusing on the role of social health protection schemes such as health equity funds in driving this change. Using baseline survey data from the evaluation of the Reproductive Health (RH) vouchers program being conducted by Population Council (N=2201), we use a binary response multilevel random effects model to examine both individual-level and community-level influences on facility-based deliveries and antenatal care use among women in three provinces in Cambodia. Preliminary results suggest that social health protection schemes as well as community-level influences are significant in determining the use of maternal healthcare services. Implications for policy development and healthcare financing programs including the targeted RH voucher program are discussed.