Uganda Voucher Plus Activity Year Four Work Plan

The Activity aims to increase safe pregnancies and deliveries with skilled attendants through the private sector in 33 districts in Northern and Eastern Uganda. The Activity uses an output-based financing mechanism to accredit and selectively contract private service providers to offer a defined voucher package of obstetric, newborn, and postpartum family planning (PPFP) services. The voucher package includes four antenatal care (ANC) visits; elimination of mother-to-child transmission (eMTCT) of HIV; facility delivery under skilled attendants, with referrals for complications; postnatal care (PNC); and PPFP. Voucher Community-Based Distributors (VCBDs) offer the voucher at a rate of 4,000 Ugandan Shillings (UGX) to eligible pregnant women. They also service youth and male partners of pregnant women by providing safe motherhood information. VCBDs have helped increase demand for safe motherhood services in the communities by reaching clients and mobilizing key community stakeholders through community meetings, client follow-up visits, and health talks in partnership with voucher health service providers (VSPs) and health implementers. The Activity supports the two development objectives (DOs) in the Country Development Cooperation Strategy (CDCS) 2.0, including DO 1, affecting demographic drivers to contribute to long-term care, and DO 2, improving key systems to be more accountable and responsive to Uganda's development needs. The two related intermediate results (IRs) include IR 1 for increased utilization of high-quality voucher-covered maternal, newborn, child health (MNCH) and family planning (FP) services in target districts and IR 2 for increased capacity of Uganda's public and private sectors to develop longer-term financing strategies. To expand use of high-quality reproductive maternal newborn child health (RMNCH) services and strengthen local capacity to implement innovative health financing mechanisms, the Activity will prioritize the following in Year 4: strengthening engagement of political, legislative, administrative, and local leaders and key stakeholders at district and community levels to use their influence and foster Ugandan-led solutions for increased utilization of MCH vouchers and RMNCH services; strengthening data demand, use, and reporting at all levels as a lever for evidence-based programming, learning, and adaptation; expanding voucher services to more private wings of public sector to improve referral system for comprehensive obstetric care and build its capacity to effectively implement results-based financing (RBF) mechanisms; and strengthening the private sector for sustainable growth and inclusion into national health financing mechanisms through business trainings and mentoring initiatives. Since inception in 2016, the Activity has accomplished many objectives and milestones, including creating demand for MNCH and FP services in the private sector by the poor in the designated program districts. The Activity has also established a voucher management agency (VMA) to manage the voucher program and has accredited and contracted private service providers to offer the voucher package of services. Additionally, the Activity has strengthened the capacity of public and private stakeholders at the national and district levels to develop longer-term financing strategies for quality health programming.