To reduce inequities in reproductive health care by enabling access to services, while empowering the below poverty line (BPL) population to choose their own providers

The Voucher SystemDemand-side Financing

IFPS II Technical Assistance Project (ITAP)

Voucher Management System

Voucher Management

Agency

Voucher Redemption

Private Nursing Homes

Voucher Redemption

BPL Families Voucher Distribution

ASHA

Voucher Distribution

ANM

Voucher Distribution

Payment forServices

The Voucher System

• Provided high-quality private sector services at deep discount rates

• Expanded services cost-effectively even with under-staffing at government facilities

• Relieved pressure on government

• Enabled clients to save money

Photos by Suneeta Sharma (top) and Simply CVR (bottom)

Some Highlights

All Below Poverty Line

Above Poverty Line

0

10

20

30

40

50

30 2931

47 47 47

Improving AccessUse of Institutional Delivery Services

Endline 2009

Baseline 2007

Use

of

Inst

itu

tion

al

Deliv

ery

Serv

ices

(%)

All Below Poverty Line

Above Poverty Line

0

10

20

30

40

50

3633

37

42 43 42

Improving AccessUse of Modern Contraceptives

Endline 2009

Baseline 2007

U

se o

f M

od

ern

C

on

trace

pti

ves

(%)

Udham Singh Nagar

Naintal

Almora

Dehradun

Haridwar

BahadrabadImlikheda

Sustainable Financing and Scaling Up

Total population coverage in pilot: 0.15 million

Total population coverage in scale up: approx. 5.36 million

USAID contribution in demonstration: USD 170,666 for 12 months

GoUK funds for scale up: USD 1,045,000 for 12 months

The Voucher Scheme in Uttarakhand, India

POLICY PAYS OFFBuilding Foundations for Sustainable Health Programs

Mobile Health Clinic: Reaching the Underserved in

UttarakhandA fixed day, fixed time, and fixed place approach to provide primary

healthcare services in remote rural areas

Jamrani

18 k

m

25 kmChorgalia

25 kmBindukhatta

HALDWANI

Maldhanchour

33 k

mThari

Amgarhi

Kotabagh

Kamola

Dhamola

20 km

25

km 35

km

25 km

BHIMTAL-BISR

30 k

m

60 km

RAMNAGAR

Total 8 sites

Visit every 15 days

Camps in a month 16

Route Map of Mobile Health Clinic

Performance Statistics (JAN 09 – DEC 09)

• 195 Camps held

• 11,352 out-patients

registered

• Average patients per camp –

59.1

• IUD insertions – 189

• Pills distributed – 1,292

cycles

• Condoms distributed (packs

of 10)– 411,00 pieces

% Female Clients %Below Poverty Line Clients

% RH clients0

10

20

30

40

50

60

7067.6

31.1

52.4

Scaling up Mobile Health Clinic Coverage & Funding

Total population coverage in pilot: 0.5 million

Total population coverage in scale up: 10 million

USAID contribution in demonstration:

Capital Costs: Nil

Operating Costs: USD 186,000

GoUK funds for scale up:

Capital costs: USD 1.97 million

Operating Costs: USD 580,000