TY - JOUR
T1 - Lessons learnt during the process of setup and implementation of the voucher scheme in Eastern Uganda
T2 - A mixed methods study
AU - Bua, John
AU - Paina, Ligia
AU - Kiracho, Elizabeth Ekirapa
N1 - Funding Information:
Approval to conduct this study was sought from the Makerere University Higher degrees Research and Ethics Review Board and the National Council of Science and Technology. Informed consent was obtained from the study participants before they were interviewed.
Funding Information:
The authors would like to acknowledge the technical support and cooperation provided by all the health staff of Buyende, Kamuli, Pallisa and Kibuku District Health offices during the design and implementation of this study. The team is grateful to the Melinda Gates Foundation and United Kingdom Department for International Development (DFID) for funding this work through the “Partnership for Building the Capacity of Makerere University to Improve Health Outcomes in Uganda”, a collaborative learning initiative with John Hopkins University and the Future Health Systems Research Programme Consortium (FHS).
Funding Information:
In an attempt to address the above constraints, Maker-ere University School of Public Health, in collaboration with Johns Hopkins University, with funding from the Melinda Gates Foundation and United Kingdom Department for International Development (DFID), piloted the Safe deliveries project. The project applied a voucher scheme with both demand and supply side initiatives.
Publisher Copyright:
© 2015 Bua et al.
PY - 2015/8/6
Y1 - 2015/8/6
N2 - Background: In spite of the investments made by the Ugandan Government, the utilisation of maternal health services has remained low, resulting in a high maternal mortality (438 maternal deaths per 100,000 live births). Aiming to reduce poor women's constraints to the utilisation of services, an intervention consisting of a voucher scheme and health system strengthening was implemented. This paper presents the lessons learnt during the setup and implementation of the intervention in Eastern Uganda, in order to inform the design and scale up of similar future interventions. Methods: The key lessons were synthesised from a variety of project reports, as well as qualitative data drawn from six focus group discussions and four in-depth interviews conducted in the Buyende and Pallisa districts during the implementation phase of the voucher scheme. Results and Conclusions: To promote the successful implementation of interventions with demand and supply side initiatives, such as voucher schemes, the health system should be able to respond to the demand created by providing the additional required resources such as health workers, essential supplies and equipment. Involving a diverse, multi-sectoral group of stakeholders is important for addressing the different barriers experienced by women when seeking maternal health services. Voucher schemes should have a mechanism of detecting unintended consequences and mitigating them. Sustainability plans should be built into such interventions to maintain the gains achieved. Lastly, health policy planners can use this information to develop follow-up programmes to test modified versions that are more sustainable. Such programmes could use locally existing community structures for management and resource mobilisation for self-sustainment.
AB - Background: In spite of the investments made by the Ugandan Government, the utilisation of maternal health services has remained low, resulting in a high maternal mortality (438 maternal deaths per 100,000 live births). Aiming to reduce poor women's constraints to the utilisation of services, an intervention consisting of a voucher scheme and health system strengthening was implemented. This paper presents the lessons learnt during the setup and implementation of the intervention in Eastern Uganda, in order to inform the design and scale up of similar future interventions. Methods: The key lessons were synthesised from a variety of project reports, as well as qualitative data drawn from six focus group discussions and four in-depth interviews conducted in the Buyende and Pallisa districts during the implementation phase of the voucher scheme. Results and Conclusions: To promote the successful implementation of interventions with demand and supply side initiatives, such as voucher schemes, the health system should be able to respond to the demand created by providing the additional required resources such as health workers, essential supplies and equipment. Involving a diverse, multi-sectoral group of stakeholders is important for addressing the different barriers experienced by women when seeking maternal health services. Voucher schemes should have a mechanism of detecting unintended consequences and mitigating them. Sustainability plans should be built into such interventions to maintain the gains achieved. Lastly, health policy planners can use this information to develop follow-up programmes to test modified versions that are more sustainable. Such programmes could use locally existing community structures for management and resource mobilisation for self-sustainment.
KW - Africa
KW - Health financing
KW - Health system strengthening
KW - Maternal health
KW - Uganda
KW - Vouchers
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U2 - 10.1186/s13012-015-0292-3
DO - 10.1186/s13012-015-0292-3
M3 - Article
C2 - 26245345
AN - SCOPUS:84938596422
SN - 1748-5908
VL - 10
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 108
ER -