Vouchers that Make Having a Baby Safe and Cheap for More Ugandan Women

Uganda has affordable health care for some of its poorest women.

Uganda has affordable health care for some of its poorest women.

  • A UShs4,000 (US$1) voucher covers antenatal visits, delivery, and post-natal care
  • Vouchers are intended for poorer women in two mostly rural regions of Uganda
  • Even the cost of assisted births, such as Caesareans, are covered

KANUNGU, May 30, 2017 – Anna Katushabe’s daughter came into the world in early May by Caesarean-section delivery, and so both mother and daughter spent longer than expected in Rugyeyo Community Hospital. Ordinarily, the longer stay would have been a worry for the young mother; for Anna, however, her C-section delivery cost only UShs 4,000, just over US$1.

The secret to keeping safe childbirth cheap lies in an innovative voucher programme that gives pregnant women affordable, effective medical attention. When she was four months pregnant, Anna bought a reproductive health care voucher for UShs 4,000. This gave her access to a health facility throughout her pregnancy, and she knew it would cover the delivery and medical care for six weeks after her baby’s birth as well.

Rugyeyo hospital is in Kanungu District, 260 miles (420km) from Kampala on Uganda’s border with the Democratic Republic of the Congo. A normal (vaginal) birth usually costs UShs 46,000 (US$13) at the hospital, while Caesarean births cost UShs 316,000 (US$88).

Uganda was the first country in Eastern Africa to use these health vouchers, starting with a pilot programme in 2006.

Funded by KfW, the German Development Bank, the pilot project, Healthy Life, subsidised the cost of treating sexually transmitted infections. The scheme expanded in 2008, when KfW and the World Bank’s Global Partnership on Output-Based Aid gave it US$6.2 million to subsidize safe deliveries as well.

The program in south-western Uganda was very successful, helping with nearly 66,000 deliveries, 130% of its initial target. Uganda’s Ministry of Health then expanded it to other districts through its Reproductive Health Voucher Project, which was funded with US$13.3 million from the Swedish International Development Agency (SIDA) through the Global Partnership on Output Based Aid (GPOBA).


Giving birth in remoter rural areas

More than 200,000 vouchers have since been sold in 25 districts in south-western Uganda and central-eastern Uganda. Marie Stopes Uganda manages the distribution of vouchers, and a poverty-grading tool is designed to help the program reach the most vulnerable women.

The project’s objective is to increase the amount of access poorer women living in disadvantaged rural areas have to skilled medical care. It covers the cost of:

  • four antenatal visits,
  • a safe delivery under skilled supervision,
  • one postnatal visit,
  • the treatment and management of some pregnancy-related medical conditions and complications, including Caesarean-sections
  • and emergency transport.

“This program started at our facility in May 2016,” Dr. Hadus Masereka, the medical superintendent at the hospital. “About 40 out of the 50 pregnant women who have ended-up delivering by C-section since, have had vouchers.” This saved the lives of women who would have been unable to afford this expensive, often emergency, procedure. Many Ugandan women deliver their babies in sometimes less-than-ideal conditions at home.

Such new health initiatives are helping reverse Uganda’s high rates of infant and maternal mortality, with maternal mortality falling from 438 to 336 deaths for 100,000 live births between 2011 and 2016, according to the Uganda Bureau of Statistics. Infant mortality has also fallen from 432 deaths to 54 per 1000 live births.

The voucher system shows that with a little money and innovation, the process of giving life does not have to be a matter of life and death for Ugandan mothers like Anna. By the end of March 2017, the project had provided help for more than 43,000 births, including 31,000 normal deliveries, 6,500 assisted deliveries, and 5,600 C-sections.

In some areas, the system has also reduced the burden public health care facilities face when it comes to childbirth care, because vouchers have made private, for-profit health centres accessible to women.

About the Uganda Reproductive Health Voucher Project

The Uganda Reproductive Health Voucher Project increases skilled medical care during pregnancy and delivery for poor women living in rural and disadvantaged areas.


By Rose Mahoro

Sexual Reproductive Health (SRH) is an essential component of the universal right to the highest attainable standard of physical and mental health, enshrined in the Universal Declaration of Human Rights and in other international human rights conventions, declarations, and consensus agreements.

Globally, most people become sexually active before their 20th birthday and according to the data from the Demographics and Health Survey, the median age of young people in Uganda having their first sexual experience is 16.4 years thus an alarming increase in teenage pregnancies and unsafe abortions. According to the data collected from Naguru Teenage Information Health Center, 64% of the clinical problems at the facility were related to STIs management. No wonder, early this year (2017), Uganda Aids Commission released a disquieting report saying 500 girls get HIV infection every week in Uganda.

This plague should be caused by scant knowledge about contraceptives and HIV and AIDS, increasing immorality among young people since social and cultural norms have largely prohibited teachers, parents and children from discussing sex, mistrust between the youth and the service providers which impairs access to youth friendly services.

The ministry of Gender, Labour and Social Development (MGLSD) tabled a shocking motion to ban comprehensive sexual education in schools which was a blow to activists who have been advocating for a more holistic sex education and a more open dialogue about sexual reproductive health that covers the psychological and emotional aspects of adolescents and helping them make more informed decisions.

Although this is happening, we shouldn’t forget Uganda’s successful response to HIV/AIDS and for this reason, it was held as a model for other countries. The government of Uganda also registered a tremendous achievement for young people in the field of SRHR by adopting policies that created an environment supportive of adolescent sexual and reproductive health. International and national organizations such as RHU, UHMG, Reach a Hand and Marie Stopes Uganda have come up with programs and interventions aimed at behavior change, advocacy and service delivery for adolescents.

Among the interventions, Marie Stopes Uganda launched SRH Ambassadors program for young people ages 18-25 years where they are trained on Sexual Reproductive Health and leadership roles to help them reach their fellow young people in and out of school who may be in need of SRH knowledge and information, refer them to appropriate facilities and empower them to make informed decisions.

In Addition, Marie Stopes Uganda runs a toll free line 0800220333. This helpline is adequately equipped to provide free and friendly counseling, information giving and referrals on SRH related matters to both female and male adolescents in a confidential manner.

Therefore, gender and human rights should be placed at the heart of sex education, service providers should be trained in providing youth friendly services, NGOs through the government should come up with interventions to increase access of free youth friendly services, stake holders, parents and children should as well work hand in hand to have a better Sexual Reproductive Health.

HPV And Cervical Cancer: The Importance Of Pap Smears


The topic of pap smears, HPV and cervical cancer is relevant to any woman who is 21 or older, so if that’s you – or your partner, friends, siblings or the women in your community – listen up and help spread the word.

Cervical cancer is one of the most common and deadliest forms of the disease, but unlike other types of cancer, it can be detected early and treated –and in some cases, even prevented before it happens. That’s where pap smears come in.

What is a pap smear?

A pap smear is a quick, simple and relatively painless procedure that can safeguard you against cervical cancer. It’s a test that doctors perform to check for the presence of cancerous or pre-cancerous cells in the cervix. When performed regularly, it’s a form of preventative healthcare as it can detect the presence of unhealthy cells before they have the chance to develop into cancer.

Pap smears take just a couple of minutes and can be performed by your gynae, or at a clinic. They’re not particularly uncomfortable, though every woman experiences them differently. Some women feel nothing at all, and other women report a little discomfort.

If a pap smear detects abnormal cells, those cells can easily be removed from the cervix before they result in cancer.

Do I need a pap smear?

Yes, if you are a woman who is 21 years of age or older. All adult women should undergo regular pap smears.

How often should I have a pap smear?

If the results of your first pap smear are normal, it’s recommended you go every three years. For women who have abnormal results, more regular testing may be required. Your doctor, clinic or gynae will advise you on how often you should be having a pap smear.

What’s the link between HPV and cervical cancer?

In the vast majority of cases, cervical cancer is caused by high-risk strains of the human papillomavirus (HPV), a form of sexually transmitted infection (STI) that is extremely common.

In some women, this STI is contracted and then suppressed by the immune system, causing only temporary changes to the cells in the cervix. This explains why some women have abnormal pap smear results, but normal results six months or a year later.

In other cases, HPV can be persistent and eventually lead to pre-cancerous or cancerous cells. Pap smears will test for abnormal cells, and if follow-up pap smears still detect these abnormalities, a simple procedure can be performed to remove the threat.

Where can I go for a pap smear?

A pap smear can be performed by your gynae or at any Marie Stopes centre across Uganda. Visit your most convenient Marie Stopes centre, and you’ll also be able to chat to us about your contraceptive options, get screened for STIs and HIV, and get personalised sexual healthcare advice.

Find your closest Marie Stopes centre or call our toll free hotline 0800220333 now and speak to our trained counselors.

Apply to become an SRH Ambassador!

Be the Choice!
Are you are young person between the ages of 18-25 years? Do you have interest in advancing Sexual Reproductive Health(SRH) within your community? If yes, Marie Stopes Uganda has a new exciting volunteering program for you.
Send us your application at info@mariestopes.or.ug including a brief biography, contact information, name of university/ institution, district/region of your university and year of study.  The application should have your motivation/application letter.

The letter should be addressed to the Head of Communications and Public Relations

In addition send us a two page write up about;

  1. any Sexual Reproductive Health challenges faced by youth in your community/school
  2.  why you would like to be an SRH ambassador.
  3. You could also share how you would solve those challenges.

For the start, we are currently rolling out the program in the following districts below namely; Kampala, Wakiso, Jinja, Tororo, Mbale, Soroti, Masaka, Mbarara, Kabale, Hoima, Fortportal,  Arua, Gulu, Lira. Youth in these areas are encouraged to apply.

Applications sent on email should be marked with the subject “SRH Ambassador” and sent to info@mariestopes.or.ug

Deadline for applications is 20th March 2017

Note: This is a volunteer opportunity and its not full time.

For more details, refer to our website (http://www.mariestopes.or.ug/) or you call 0800220333 toll free.

Information Sharing Meeting on Uganda Reproductive Health Voucher Project(URHVP)

Marie Stopes Uganda in partnership with the Ministry of Health was honoured to organise an information sharing meeting for all stake holders from the 25 districts where the (Uganda Reproductive Heatlth Voucher Project (URHVP) project is being implemented, Health Development partners and other agencies implementing results based financing programs to review progress of project implementation at Lake Victoria Serena Lweza on Tuesday 28th February, 2017.

Hon. Opendi Achieng Sarah gave a key note address at the meeting.

Hon. Opendi Achieng Sarah gave a key note address at the meeting.

This project is aimed at increasing access to skilled care among poor women living in rural and disadvantaged areas during pregnancy and delivery. The project is supported by the Swedish Government, the World Bank Group and UNFPA.

The project has been implemented since September 2015  and has managed to expand skilled care among poor pregnant women in the project districts.

To date, over 65,000 women have so far benefited from this project.

The Hon. Opendi Achieng Sarah with some of the key staff of Marie Stopes

The Hon. Opendi Achieng Sarah with some of the key staff of Marie Stopes namely the Country Director(Left) and the Managing Director(right) and the Head of Communications(far left).

Press Release in Response to News Article

Marie Stopes Uganda would like to respond to media reports titled “ Couple sues Marie Stopes over unplanned child”.

Marie Stopes Uganda is not aware of any law suit commenced by any of its clients to whom it has provided sexual and reproductive health services. Marie Stopes Uganda has provided sexual and reproductive health services to millions of Ugandans and our clients are always informed and understand that no method of contraception has 100% success rate.

We remain committed to our mission of helping women have children by choice, not chance and will continue to provide the high quality services that our clients know us for.

MOH Permanent Secretary visits URHVP

MOH Permanent Secretary visits URHVP

 The Permanent Secretary Dr Diana Atwiine (4th right), MD Marie Stopes Dr Carole Sekimpi (2nd left) in a group photo with the URHVP team.

The Permanent Secretary Dr Diana Atwiine (4th right), MD Marie Stopes Dr Carole Sekimpi (2nd left) in a group photo with the URHVP team.

The Uganda Reproductive Health Voucher Project (URHVP) recently conducted a field visit with a high powered delegation led by the new MoH Permanent Secretary Dr Diana Atwiine. It was a great platform to discuss how best results based financing can be operationalized to get out puts out of both public and private players in Uganda’s health sector. The team visited a number of centres in the East that are supported by the URHVP program.

The Uganda Reproductive Health Voucher Project (URHVP) is a Ministry of Health program being implemented in partnership with Marie Stopes Uganda (MSU) with support from the World Bank. The overarching goal of the URHVP is to reduce maternal and perinatal mortality and morbidity through increased access to skilled care (Voucher Based Services) during pregnancy, delivery and postnatal period.

Uganda has high maternal mortality ratio of 438/100,000 live births, 435/100,000 live births in 2006 and 524/100,000 live births in 2000. A perinatal mortality rate of 27/1000 pregnancies in 2011, 46/1000 pregnancies in 2006 and 55/1000 pregnancies in 2000.

This four years project is currently being implemented in the South- Western and Eastern districts of  Uganda in Mbarara, Kabale, Kanungu, Ntungamo Kiruhura, Sheema, Buhweju, Mitooma, Ibanda, Isingiro, Bushenyi ,Rubirizi, Rakai, Sembabule, Masaka, Jinja, Kamuli, Buyende, Kaliro,  Luuka, Mayuge, Iganga, Namutumba, Kibuku, Tororo,  and Namayingo.


Request for Consultancy Services to develop a Promotional Video for MSU


National Drug Authority has recently approved the registration of MSU’s brand of mifepristone, Mediprist. Mediprist is a lifesaving drug used to treat women in need of medical post abortion care in cases of missed abortion.


MSU has imported this drug and is currently distributing it through ABACUS pharma LTD. As a relatively new drug in the Ugandan market, many providers are unaware of what the product is, what it does and how it can and should be used in the Ugandan legal context. MSU will hold a launch for the product in early February for medical practitioners, CSO’s and other advocates.


As part of the launch and future engagements MSU would like to develop a short video (no more than 5 minutes) to highlight some of the key facts about the drug, how it is being used elsewhere in the world, some personal stories of women who have used the drug in life saving treatments and victims of unsafe abortion who would have benefited from this drug. The video will also provide a contextual background on the magnitude of Maternal Mortality due to unsafe abortion in Uganda. MSU expects some medical practitioners to have a certain amount of stigma about mifepristone and the video should be used to reduce these negative perceptions.





–   Provide the creative concept, design, production and edited video to support the launch of Mediprist.

–   Provide a 1 – 2 minute shortened, edited version of key highlights for use in future trainings.



– Framework advertised December 5th

– Creative concept outline submitted   December 12th

– Contract awarded by December 19th   

– Script pretest by January 9th

– Approval of final script by January 18th

– Production commences on January 19th

– First edit of the film to be submitted to MSU by February 3rd

– Final film and shorter edit to be submitted by February 13th


–   The film should be produced in English

–   MSU is open to a mix of live action and animation

–   MSU will provide all the required technical information and support necessary regarding the product


Request for Bids to provide Behavioral Change Communication services(Road shows) and printing services

Request for Bids to Provide Behavioural Change Communication (BCC) and
Printing Services
1.0 Background
1.1 A brief over view of the Maries Stopes Uganda (MSU)
Marie Stopes Uganda (MSU) is a marketing-focused, results-oriented social business that uses
modern management and marketing techniques to provide family planning and reproductive
healthcare across every district of Uganda.
To date, MSU enjoys 25% of the market share in modern contraceptives and, by 2010/2011, it
directly contributed to safely delivering 50,000 babies. It also, contributed 4 points to Uganda’s
contraceptive prevalence rate. MSU has enjoyed 20% year on year growth since 2007 and it is
part of the Marie Stopes International (MSI) global network subscribing to her goal and mission; “to
prevent unwanted births and to ensure individual’s rights to Children by Choice not Chance”.
In Uganda, Marie stopes operates an active social marketing unit that works to expand access to
condoms, by implementing demand generation for general condom use in the country. This is
implemented under the total market approach strategy developed by the Ministry of Health (MoH).
MSU in partnership with MoH has undertaken a strategic review of its business and recognizes the
need to increase demand for condom use in the country by focusing on most at risk populations
(MARPs) located in specific districts and along particular transit corridors.

2. Overall objective of the assignment
The main purpose of this assignment is to support MSU demand generation activities to overcome
market barriers and contribute to successful condom use, behaviour change in the country.

2.1 Specific Objectives
Specifically, increasing demand for the condoms is intended to:
 Improve indicators relating to STI/HIV infections in the country
 Increase utilization rates for condoms and thus avoid wastage
 Further promote the total marketing approach which will ensure improvement in condom
use and reduced unintended pregnancies
 Allow for cross-selling of other condom brands and generics to achieve desired services

3.0 Scope of Behavioral Change communication and printing services
The assignment will involve conducting comprehensive behavioural change communication drives
and publicity services. Each task is categorised as a lot. Bidders are free to quote for all allots, BUT
no bidder shall be awarded more than one lot.
In case of quoting for more than one lot, bidders are required to indicate the order of priority in the
event that a bidder emerges as the best evaluated in more than one lot.

3.1 Lot 1: Sensitize the masses through road shows;
This will include sensitizing the clients through road shows at divisional levels in central region and
district levels in the respective districts of implementation. The road show launch shall be with
participation of MSU staff, involve hire and branding of rigs, music and distribution of promotional

Sensitize the masses through engaging them with music in local languages of the regions as per
the agreed work plan, behaviour change communication effected during the shows. During the
conduct of road shows; the firm will be expected to carry out the following:
– Branding at least 3 trucks, vehicles to promote the use of ccondoms
– Hire of Motor cycles (bodaboda)/ bicycles 20 per district for the activity
– Involve local ambassadors/celebrities/musicians in mobilization
– Deployment of at least 10 foot soldiers to sensitize the masses
– Distribution of condom promotional materials
– Sensitizing the gatherings at each of the venues

3.2 Lot 2: Provision of printing services
The following materials shall be required, hence a firm should provide quotes for the unit cost of
producing the following.
– Round neck and collar Lifeguard branded T-shirts with MSU hotline number
– A2 posters Lifeguard branded
– Lifeguard bamber stickers
– Reflector jackets
– Head Caps branded with lifeguard

The Road Show will cover 16 Major Districts; Kampala, Wakiso, Jinja Mayuge, Bugiri Namayigo, Masaka, Mpigi, Kalangala, Buikwe, Buvum, Amolartar, Busia (MARP Most at Risk Areas)
For further technical details, please note; the firm (s) must commit to undertake the
a) Submit documents detailing;
– Technical and financial proposal
– Key professional staff and demonstrate their competence for the assignment
– Organization and Staffing
– Methodology
– Work plan
– Detailed activities
– Mechanism for monitoring
– Mechanisms for feedback to MSU
Additionally, in the course of conducting the activities, each firm is expected to carry out the
– Liaise with MSU Head of social marketing and district management in the conduct of the
– Adhere to the police and town councils roadmap in the conduct of the activity
– Conduct the exercise professionally and impartially
– Provide MSU with a record of all activities undertaken and feedback from the targeted
audiences that would assist MSU to improve behaviour change communications activities in
– Submit progress reports to MSU &
– Submit final report at the end of the assignment

4.0 Support from MSU
 Provide promotional materials for use in behaviour change communication
 Develop materials/messages to be used
 Train/orient key personnel of the firm
 Provide staff to handle the technical backup
 Supervise and monitor activities of the firms
 Liaise with condom distributors to avail products during promotions

5.0 The Firms’ role will include;
 Conduct road shows during behaviour change campaigns .
 Document road show activities and share reports
 Submit reports to MSU on the road shows and promotion/demand generation activities.
6.0 Time frame
This exercise will be conducted within a period not exceeding 4months depending on availability
of funds
7.0 Payment arrangements
Payment will be made based on submission of invoices, 60% down payment before
commencement of activities. Please note; No Travel expenses will be reimbursed the figure quoted
should cater for all expenses
8.0 Supervision and Management
The MSU – Head social marketing will provide the overall management and supervision function
during the time of this assignment.
9.0 Deliverables/Expected Outcomes
– Dentailed printed monthly activity reports with any recommendations will be submitted &
– Soft copy of final activity report will also be shared.
10.0 Qualifications and Requirements
The Firm (s) to carry out this assignment shall have the following profile:
 Competent Firms with proven work experience in mass sensitization, printing in Uganda in the
last 3 years and demonstrate ownership of at least 3 Rigs.
 The firms should have carried out at least 3 similar assignments.
 The firms should demonstrate experience in carrying out demand generation for public health
 The firms should demonstrate capacity to effectively conduct the assignment.

11.0 How to apply
Interested applicants should send their proposals (Technical & financial) that show their
qualification and experience to make them appropriate for the assignment. Proposals should be
delivered to the MSU,
The Procurement & Logistics Unit,
Marie Stopes Uganda,
Plot 1020 Kisugu – Muyenga,
P. O. Box 10431,
Clearly marked “BID FOR BCC ACTIVITIES” at or before 3:00pm on 9th December 2016. Late
submissions shall be rejected.