Summary

Program goals

The program's primary objectives are to reduce the disease burden associated with maternal delivery and STIs and to make health care delivery more accountable by linking services to reimbursement.

Key program components

The voucher program for STI treatment has been in operation since 2006 and in 2008, with additional funding from the German Development Bank (KfW) and the Global Partnership for Output-based Aid (GPOBA), added a number of safe motherhood components of antenatal care, maternal delivery, and postnatal care under the HealthyBaby banner.

In the HealthyLife program, non-HIV STI cases are seen at contracted clinics. Patients receive basic laboratory diagnostic services, are seen by a provider (nurse, clinic officer or medical doctor), and prescribed drugs if needed. HealthyLife vouchers are distributed at drug shops, pharmacies and targeted behavior change campaigns to anyone at risk of STIs. No poverty grading is used for HealthyLife sales. The "double" voucher (one for each partner) costs 1500 Ugandan shillings (US$0.75). These are sold through pharmacies, where an initial diagnosis has been made.

For the HealthyBaby program, mothers are provided four antenatal visits, a full delivery service including c-section if needed, and a postnatal care visit at six weeks. HealthyBaby voucher distributors are responsible for targeting poor pregnant women through a district customized poverty grading tool applied by community based distributors (CBDs). Women can purchase the voucher for 3,000 Ugandan shillings (approximately US$1.50) from a network of Community Based Workers (CBW).

The program has now contracted 100 private facilities in 22 districts in Uganda while the non-HIV STI treatment services have since expanded from 13 to 30 private facilities in southern and western Uganda in 2010.

In the first HealthyLife program, the treatment target was 20,000 vouchers. In the first 20 months of the program, there were 19,000 STI client visits. In the expanded phase (new HealthyLife and HealthyBaby services) the new client goals were over 50,000 deliveries and 30,000 STI client visits.

By December 2009 more than 17,000 delivery vouchers and 4,700 STI vouchers were sold.