On September 30, 2020, the Voucher Plus Activity, a project of the U.S. Agency for International Development (USAID) to expand and improve access to quality maternal and newborn services will close. Christine Namayanja, the chief of the party spoke to Health Journalists Network in Uganda (HEJNU) about the achievements of the vouchers and the journey to sustainability after five years of operation in 36 districts in Northern and Eastern Uganda.
Qn 1: What was the USAID Voucher Plus Activity about?
Ans: The USAID Voucher Plus Activity, which started in January 2016, ensured that poor pregnant women have access to quality maternal health care and family planning services by providing them with a health care voucher at a fee of UGX 4000. The voucher enabled the women to access maternal and newborn services from private health providers within their geographic area.
Qn 2: What were the achievements over the five years?
Ans: As a result of the assistance from the American people, the Activity enabled over 194,800 safe deliveries at 146 private health facilities. Voucher Plus Activity, expanded and improved access to quality maternal and newborn services in 36 districts in Northern and Eastern Uganda. It ensured that all women and children have the same opportunities for a healthy life, regardless of where they are born.
Qn 3: Where did the beneficiaries access the services?
Ans: Voucher Plus Activity, a USAID project worked with private healthcare providers to deliver quality, safe births and newborn services through training, equipping the facilities, linking the facilities to district health teams for vital supplies, licensing, and reporting into the national health information systems.
Qn 4: Why did the project particularly work with the private sector?
Ans: USAID recognizes the increasing role that the private sector plays in reducing preventable maternal and child deaths. But also the private sector is an inextricable stakeholder in driving and sustaining outcomes capable of moving countries beyond the need for assistance. The private sector creates nine out of ten jobs in the developing world, and it is the driving force behind new innovations that solve problems and has the scale and resources to match the complexity of challenges countries face on their journey to Self-Reliance.
USAID also has a policy, the journey to self-reliance, that is being applied to all the USAID funded projects with a goal to end the need for foreign assistance. This policy recognizes that the private sector is one of the most powerful forces for lifting lives, strengthening communities, and accelerating countries to self-reliance.
Qn 5: Will the gains you had in the USAID Voucher Plus Activity be sustainable?
Ans: Voucher Plus Activity built partnerships between the district and private providers that will enable private health facilities to take charge and continue to provide quality, affordable, and equitable health care to their communities. The staff at the private sector facilities where we worked received mentorship, training, and were able to deliver high-quality services. We expect that the private sector will thus retain their skilled health workers and provide high-quality care for communities to thrive. They were also connected to their respective district health system. These public-private partnerships are important for sustainability.
Qn 6. How did the public-private partnership work?
Ans: By linking the public and private sectors through initiatives like Voucher Plus Activity we were able to create discussions between the two entities through the district offices and creating closer links. District leaders actively participated in demand generation activities that increased awareness and stimulated demand and utilization of maternal and child health services at both public and private health facilities. Voucher Plus Activity also improved data input into the government database for national planning which strengthens the health system and improves health outcomes across all facilities. Most importantly we changed the mindset of the private sector players so that they deliver high quality and standardize their services.
The improved relations and visibility of private providers at Districts will attract new IPs interested in improving access to services at the community level as well the private sector is now better positioned to compete for any new Health care financing mechanism.
Qn 7: Will the communities continue seeking these services from the private sector after the project when they are not subsidized?
Ans: Voucher Plus Activity has fostered new relationships with very poor women and their partners who had previously not accessed services through the private sector. In collaboration with Health Partners Uganda, another USAID funded project, we extended Community Health Insurance in a number of areas in the north and eastern Uganda. This is already taking shape in some of the districts we worked with and we are hopeful such an innovative, yet sustainable health financing option will be massively embraced to protect these poor families from financial hardships when seeking healthcare.