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The Reproductive Health Voucher Project
Christine NamayanjaMarie Stopes Uganda2 May, 2012
Defining Output-Based Aid (OBA)
A performance-based subsidy that is payable on the achievement of measureable results.
Services contracted out to a third party (service provider, which can be a private or public service entity)
Service providers are - for the most part - reimbursed after delivery of the (pre-) agreed output
Subsidy funding generally from public sources
2
The HealthyBaby Concept
For women identified as poor
• A voucher, offering her:– 4 antenatal visits
– Transport to a health facility for delivery (NEW)
– A safe delivery, regardless of how complicated
– Transportation between facilities in case of referral
– Postnatal care
• All in a private facility where the quality is ensured and monitored
•Funded by the World Bank (GPOBA) and KfW and implemented in partnership with the MoH•Over 100,000 vouchers sold•Over 60,000 babies safely delivered •Over 80,000 women received ANC •Allowed many providers to invest in their facilities
Previous Programme
Impact• Reduced the cost barrier facing women seeking
maternal health services• Improved knowledge of danger signs in pregnancy /
childbirth and of STI’s among women who are exposed to the voucher programme
• Reduced socio economic inequity in service utilization
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4+ ANC visits Facility delivery
No voucher user present in village
Poorest 40% Least poor 40%
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4+ ANC visits Facility delivery
Voucher user present in village
Poorest 40% Least poor 40%
Impact (2)• Increased satisfaction with services – 98% of voucher
clients were satisfied with the services they received, as opposed to 76% of non voucher clients
• Increased utilization of safe motherhood services by poor women exposed to the programme
• Even among poor women, the very poorest were the ones most likely to use the voucher
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4+ ANC visits Facility delivery Postnatal care
No voucher user present in village
Before program During program
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4+ ANC visits Facility delivery Postnatal care
Voucher user present in village
Before program During program
