BACKGROUNDGreenmash was commissioned by Population Services

International (PSI), to design, configure and deploy an

application in support of a medical subsidy programme

providing beneficiaries with easy access to vital healthcare

in Tanzania.

eVoucherseVouchers are electronic ‘vouchers’ that can be distributed

via SMS and other mobile technologies. They enable PSI to

offer targeted discounted or free vouchers for certain health

services providing beneficiaries better access to critical

health services they may otherwise not be able to afford. The

eVouchers and Referral application is now available as a

module for the Mango mobile application platform.

CHALLENGEOffering monetary subsidies is always a tricky endeavour.

You have to ensure that the right person will receive the

right subsidy and that this subsidy cannot be transferred

or redeemed for anything other than its intended purpose.

Aside from fraud prevention, you also need to have a tracking

system in place to ensure vouchers are actually being used,

send reminders to beneficiaries to use them and identify

where the voucher has been redeemed.

The referrer needs to be rewarded as does the service

provider. The beneficiary needs to be registered for any

follow up service, sent reminders and also incentivised to

encourage friends and family to take advantage of the health

services available.

Vouchers must also be easily and widely available. They

need to be acceptable to service providers and trusted

by all parties as means of payment for a quality service.

A cost effective voucher system needs to be flexible to

accommodate changes to costs and to allow for the provision

of additional services.

Major issues identified:

✘ Paper based vouchers are too susceptible to fraud,

difficult to distribute at scale, and cannot be easily

modified to unique or changing circumstances.

✘ Paper based vouchers are very difficult to trace and audit

for financial purposes.

✘ A paper based process limits the ability to quickly and

effectively verify that a beneficiary is entitled to the

voucher benefit.

✘ Demand for vouchers can be very unpredictable in the

short term.

✘ Paper vouchers can be lost, damaged and copied

all of which create additional challenges for program

managers and service providers.

Goals & RequirementsThe following requirements were specified for the eVoucher solution:

✔ An ability to produce vouchers on demand for essential

treatments.

✔ Collect key beneficiary data that can be used across

multiple health programmes.

✔ Manage multiple voucher values and expiry dates based

on location and programme.

✔ Deliver a randomised and unique voucher number, along

with a unique beneficiary ID number.

✔ Provide a verification mechanism for health facilities to

ensure that the correct person is receiving the benefit

and enable redemptions to be automatically logged for

payment.

✔ Provide an approval process and payment system, with

a resulting payment file.

✔ Provide real time reporting to PSI and donors to inform

and assist with programmatic decisions.

✔ Enable auditability to ensure transparency and

traceability of the whole process.

✔ More effective and efficient payments to health workers

and service providers.

+44 20 8224 1740 info@greenmash.com greenmash.com

PSI TANZANIA

eVoucher Solution to Subsidise HIV, Cervical Cancer, & Child Health Referrals

CASE STUDY

✔ More predictable and controllable financial liabilities to

funding organizations.

✔ Create mechanisms and reporting to help prevent fraud

or voucher misuse.

The goals of the program included:

✔ Increase uptake of essential treatments for HIV, cervical

cancer, and child health services.

✔ Improve the performance of health workers with

immediate feedback and rewards.

✔ Ensure that the right people are getting prompt

treatment.

SOLUTIONGreenmash designed, configured, and deployed a technology

solution using the Mango platform; working closely with all

stakeholders to ensure that requirements were met. The

solution takes advantage of multiple mobile technologies

including USSD for the creation of the Unique Identity Code,

SMS for the distribution of the vouchers and mobile money for

the health worker and service provider payments.

A major advantage of a electronic voucher is that they

can be quickly created and distributed at any scale. They

can be configured on-the-fly to suit any purpose within

the boundaries of the programme. Beneficiaries can be

encouraged to use their vouchers promptly by setting an

expiration date and can be sent an automatic reminder

when that date is approaching.

✔ The eVoucher system was implemented to create,

distribute, redeem, and track electronic vouchers in one

platform; thereby making the whole process seamless.

✔ eVoucher values and expiry dates are adjustable based

on beneficiary location (e.g. rural or urban) and service

provided (HIV, cervical cancer, or child health).

✔ eVoucher tracking and redemption are available to

all PSI clinics, with the ability to include non-PSI clinics

as needed.

✔ End-to-end case management and patient tracking

is now available regardless whether the patients have

redeemed an eVoucher. It is also possible to see all

referrals provided to any beneficiary, and which service

providers were used to redeem any voucher.

✔ eVoucher data can be automatically and immediately

shared across any data management system including

DHIS2.

✔ The referral and voucher process now has a clear and

transparent audit trail. It is now possible to quickly find

out who is making referrals and providing services, while

ensuring that they are paid promptly.

RESULTSImpressive results are being achieved through the Mango

deployment.

✔ Number of referrals more than doubled within a few

months of launch.

✔ Financial liabilities are now easier to manage and more

predictable because the number of active eVouchers is

always known.

✔ Since vouchers also expire, there is no outstanding

liability beyond the expiration date..

✔ Health workers are now paid faster and more efficiently

which is a major incentive.

✔ Participating clinics are now able to predict how much

funding they will receive, and are paid electronically on

a monthly basis based on all redeemed vouchers.

✔ Major reduction of manual processes for referrals.

✔ Major improvements to health worker performance.

✔ Major improvements to health service uptake.

✔ Automatically generated reports and alerts ensure better

program performance monitoring.

✔ Only 1-day training session was required for participants.

Conclusion✔ Mango is capable of providing tremendous benefits

and offers a solution whenever greater visibility, data

accuracy, and consistent reporting are crucial for

improving health outcomes. Mango-powered solutions

also work very well in areas with poor and/or unreliable

access to communications infrastructure.

✔ Mango deployments deliver significant benefits including

dramatic savings in time and money required to collect,

manage and report on health information.

✔ Data sharing is improved with real time access available

to any stakeholder anywhere in the world.

✔ Mango is easily integrated with other management

systems including DHIS2

✔ Mango can be configured and deployed by users to

create their own mHealth systems

✔ Alternately Greenmash can design and deploy the

solution as a technology partner enabling users to take

advantage of our technical expertise and experience

whilst focusing on the management of the program.

+44 20 8224 1740 info@greenmash.com greenmash.com

Ask us today how Mango and Greenmash can help you.