Online Program

284920
Accredited private sector services coupled with affordable vouchers increase access to and quality of care: The healthy mothers, healthy babies voucher program


Tuesday, November 5, 2013

Meira Neggaz, MALD, Marie Stopes International-US, Washington, DC
Sayaka Koseki, MBA, MPH, International Health Division, Strengthening Health Outcomes through the Private Sector (SHOPS) Project, Abt Associates Inc., Bethesda, MD
Bernadette Lee, MPH, MA, International Health Division, Strengthening Health Outcomes through the Private Sector (SHOPS) Project, Abt Associates, Inc., Bethesda, MD
Alex Bagora, Marie Stopes Uganda, Kampala, Uganda
Tanvi Pandit-Rajani, MPH, International Health Division, Strengthening Health Outcomes through the Private Sector (SHOPS) Project, Abt Associates, Inc., Bethesda, MD
Ilana Ron Levey, MSc, International Health Division, Abt Associates Inc., Bethesda, MD
While Uganda has made strides to reduce poverty and progress towards the MDGs, reproductive health challenges remain. Maternal mortality remains high at 310 per 100,000 live births. While 42 percent of women deliver with the assistance of skilled medical personnel, inequities among wealth quintiles persist. The USAID-funded SHOPS (Strengthening Health Outcomes through the Private Sector) project works to meet the comprehensive obstetric care needs of poor women in Western Uganda. The healthy baby voucher program enables women to access the complete range of obstetric care – antenatal care (ANC), safe delivery, referrals, transportation, postnatal care (PNC), immunization, and postpartum family planning – for 3,000 Ugandan Shillings (about $1.20). Targeted behavior change communication (BCC) provides information on reproductive health and safe delivery, and community-based voucher distributors bring vouchers, information, and follow-up to clients. The program has already nearly met or surpassed its program goals, including: 10,887 sold vouchers (target: 10,888); 9,646 first ANC visits (target: 9,799); 5,910 safe deliveries (target: 6,533); and 2,400 PNC visits (target: 2,613). The voucher program has improved obstetric care quality in the private health sector through facilities accreditation, provider training, and regular monitoring and evaluation. High demand encouraged by frequent, well-received BCC, accessible facilities, transportation vouchers, and targeted community outreach have contributed to high uptake of services far exceeding expectations. The private sector offers an opportunity to provide high-quality obstetric services. Coupling private sector providers with low-cost vouchers and quality assurance mechanisms strengthens the health system and supports a reduction in maternal morbidity and mortality.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Describe how voucher programs can meet the comprehensive obstetric care needs of poor women who would normally not have access to private medical care. Identify the elements necessary for reaching high redemption rates of vouchers.

Keyword(s): Access to Health Care, Pregnancy Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Africa Regional Manager on the USAID-funded Strengthening Health Outcomes through the Private Sector (SHOPS) project and have extensive experience managing and implementing research which seeks to quantify and explain health outcomes achieved through the private (commercial and not-for-profit) health sector.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.