USAID|Uganda Voucher Plus Activity Annual Report Year 3 October 2017–September 2018

The goal is to reduce maternal and neonatal morbidity and mortality in 35 districts of Eastern and Northern Uganda. The Activity is implementing an output-based financing mechanism, a demand-side instrument of results-based financing (RBF) that involves three interwoven approaches: supply side, demand side, and systems strengthening. The Activity builds demand for vouchers through Voucher Community-Based Distributors (VCBDs) who offer vouchers at 4,000 Ugandan Shillings (UGX) to eligible women. The VCBDs provide safe motherhood services, including antenatal care, delivery services, and postnatal care, at participating health facilities. The Activity also strengthens the capacity of health facilities to provide quality maternal health services, including training of health workers and provision of equipment and supplies. The Activity is being implemented in 35 districts of Eastern and Northern Uganda, including Agago, Alebtong, Amuria, Amuru, Apac, Budaka, Bulambuli, Bukedea, Butebo, Butaleja, Dokolo, Gulu, Kaberamaido, Kapchorwa, Katakwi, Kitgum, Kole, Kumi, Lamwo, Lira, Manafwa, Mbale, Ngora, Nwoya, Omoro, Otuke, Oyam, Pader, Pallisa, Serere, Sironko, Soroti, Namisindwa, Kwania, and Kapelebyong. The Activity is being implemented by Abt Associates, with support from several sub-awardees, including Communication for Development Foundation Uganda, PricewaterhouseCoopers, and BDO Uganda. The Activity has made significant progress in increasing the use of maternal health services among poor pregnant women in the target districts. According to the Activity's monitoring and evaluation data, the number of women accessing antenatal care services has increased by 25% compared to the baseline, while the number of women delivering at health facilities has increased by 30%. The Activity has also reported a significant reduction in maternal and neonatal morbidity and mortality in the target districts. The Activity's success can be attributed to its innovative approach to increasing access to maternal health services, which includes the use of output-based financing and community-based distributors. The Activity has also strengthened the capacity of health facilities to provide quality maternal health services, which has contributed to the reduction in maternal and neonatal morbidity and mortality. The Activity has also made significant progress in strengthening the capacity of health facilities to provide quality maternal health services. The Activity has provided training to health workers on maternal health care, including antenatal care, delivery services, and postnatal care. The Activity has also provided equipment and supplies to health facilities, including ultrasound machines, delivery beds, and medical supplies. The Activity's success has also been recognized by the Government of Uganda, which has acknowledged the Activity's contribution to the reduction in maternal and neonatal morbidity and mortality in the country. The Activity has also been recognized by the World Bank, which has provided support to the Activity through a grant. The Activity will continue to implement its innovative approach to increasing access to maternal health services, including the use of output-based financing and community-based distributors. The Activity will also continue to strengthen the capacity of health facilities to provide quality maternal health services, which will contribute to the reduction in maternal and neonatal morbidity and mortality in the target districts.