The first documented, large scale use of output-based vouchers for healthcare in low-income countries was done in Taiwan during the 1960s and 1970s. The Taiwan Ministry of Health offered male and female sterilization services at a range of government and private facilities (see Cernada and Chow 1969). The system was set up to subsidize the cost for low income couples, targeting the service to couples with two or more children. The program also wanted to be efficient so as to save funds and increase the number of qualified couples who could use the program. The voucher subsidized a routine health service in which all couples seeking sterilization participated, regardless of their income level. Couples that did not qualify for the subsidy purchased their voucher and selected their provider. Low-income couples did not pay the fee but received the same voucher, chose from the same network of providers and received the same level of care (see Lin and Huang 1981).