Strengthening Uganda’s Health System Saves Lives

The difficulty of accessing affordable, quality healthcare is a concern around the world, and Uganda is no exception. The maternal death rate is high, and the newborn mortality rate has remained steady for 15 years. Meanwhile, the cost of care has traditionally been difficult to cover for mothers in rural areas. To break this trend, USAID joined with Uganda’s Ministry of Health to create the Abt-led Uganda Voucher Plus Activity.  

The Activity partners with the private sector to build Uganda’s capacity to  provide newborn and postpartum family planning (PPFP) services for poor women. Those services include offering facility-based deliveries--with skilled attendants--in 30 districts in the country’s Northern and Eastern regions. 

Healthier Private Sector = Healthier Families
Both patients and providers benefit from the program. Accredited service providers are recruited from the private sector and contracted to provide obstetric, newborn and PPFP services. These include four antenatal care visits, services to prevent mother-to-child transmission of HIV, delivery with skilled attendants, referrals for complications and postnatal care.

The activity trains the facilities to provide some of these services, enhancing their value, and then reimburses them for their services. Facilities submit claims to the Voucher Management Agency, which reviews them and reimburses based on services provided. Meanwhile, these same facilities pay for vouchers that are then distributed to poor women in rural areas by volunteer Voucher Community Based Distributors. The vouchers are subsidized by the Activity, too, and the cost of 4,000 UGX (equal to $1) means safe, affordable care is available to these expecting mothers—the cost typically would be more than 200,000 UGX (or $54).

In the first two and a half years, approximately 150,000 vouchers were distributed, leading to almost 70 percent attendance at the first antenatal care visit and more than 96,000 births with skilled attendants. Nearly 100 percent of mothers were tested for HIV and then guided to treatment.

“The Uganda Voucher Plus program is a fantastic example of what Abt does,” says Abt Chief of Party Christine Namayanja. “We’re building capacity, strengthening health care systems—and private sector providers—and, most importantly, doing work that makes people healthier, happier and safer.”

Hear from some of the Activity’s beneficiaries: Power of the Maternal Health Voucher

Learn more about Abt’s work: Leading Uganda Voucher Plus Activity