URHVP is a follow up to the successful maternal health voucher scheme (Healthy life and Healthy baby) implemented in Western Uganda from 2008-2012. The project finances the demand side through use of vouchers to reduce the likelihood of out-of-pocket payment for deliveries among women in communities served by the program. The four year Ministry of Health (MOH) project kicked off in September 2015 .It is funded by the Swedish Development Agency (SIDA) ,World Bank ,United Nations Population Fund (UNFPA). It is implemented by Marie Stopes Uganda (MSU) as the Voucher Management Agency (VMA) while BDO is the Independent Verification and Evaluation Agent (IVEA).

URHVP is  implemented in 12 districts of South Western Uganda (Mbarara, Kabale, Kanungu, Ntungamo Kiruhura, Sheema, Buhweju, Mitooma, Ibanda, Isingiro, Bushenyi, Rubirizi) and 13 districts of East and Central Uganda (Jinja, Bugiri Kamuli, Buyende, Kaliro, Luuka, Mayuge, Iganga, Namutumba, Kibuku, Tororo, Namayingo and Busia). The primary beneficiaries are the poor and vulnerable pregnant mothers resident within the catchment areas of the contracted health facilities. The contracted Voucher Service Providers (VSPs) and surrounding communities are the secondary beneficiaries.

The project overall aim is to increase access to skilled care among poor women living in rural and disadvantaged areas during pregnancy and delivery.

The project targets 3 key outputs;

  1. Support 142,400 pregnant women to deliver under skilled attendance;
  2. Out of all the vouchers purchased by pregnant women,70% are redeemed to support deliveries in a health facility;
  3. 90% of pregnant women enrolled under the project attend at least one ante natal care visit (ANC 1).

The project comprises of two components.

  • Package of Safe Delivery Services to Poor Pregnant Women.
  • Capacity Building and Project Management

The package of services consists of: four antenatal visits, safe delivery, one postnatal visit, Family Planning ,treatment and management of selected pregnancy-related medical conditions and complications (including caesarean sections), and emergency transport. The package also includes services for Elimination of HIV transmission from mother to child (eMTCT) as part of antenatal care. The VMA takes lead in implementing component one. The specified services are provided by the contracted VSPs that later submit reimbursement claims together with the appropriate voucher coupons to the VMA for settlement at the negotiated and agreed fees.

The pregnant mothers purchase vouchers at Uganda shillings (UGX) 4,000 (US$1.60) from members of Village Health Teams (VHTs) in their areas of residence. A combination of geographical targeting (based on poverty mapping) and a customized poverty grading tool is used to select eligible beneficiaries.

As at March 2017 a total of 247 health facilities were identified, assessed and contracted from both Public, Private not For Profit (PNFP) and Private for Profit (PFP) as illustrated below.

South  Western Region Eastern Region
Service Type Private (PFP/PNFP) Public Total Service Type Private (PFP/PNFP) Public Total
BEmOC 80 12 92 BEmOC 42 74 116
CEmOC 12 18 30 CEmOC 4 5 9
Total 92(75%) 30(25%) 122 Total 46(37%) 79(63%) 125

Component two supports project management functions including building national capacity to mainstream and scale up implementation of safe delivery voucher scheme in the health sector.

With the direct supervision and guidance from MoH, MSU has trained service providers (midwives) on the Basic Emergency Obstetric Care (BEmOC) package (ALARM) and Post-Partum Family planning (PPFP). The project has also trained Doctors and Anaesthetic officers in Comprehensive Emergency Obstetric Care (CEmOC) services.

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).

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.


ToR for Documenting results from the recently concluded Uganda Reproductive Health Voucher Project (URHVP) Health Facility Assessment



November 2016

  1. Background of the URHVP

The URHVP is a 4 year Ministry of Health (MoH) project, whose over aching goal is to increase access to skilled care among poor women living in rural and disadvantaged areas during pregnancy, delivery and the post-natal period. URHVP is a result/output based project funded by the World Bank, and implemented in partnership with Marie Stopes Uganda as the Voucher Management Agency (VMA). It is currently under implementation in the South Western and Eastern Uganda.  URHVP intend to contribute to reducing both the demand and supply side challenges such as financial barriers, distance to health facilities among others, that continue to hinder access to skilled attendant at child birth.

The development objective of URHVP is to increase access to skilled care during pregnancy and delivery.  URHVP  is made up of two components: (a) safe delivery component with the objective to provide subsidized vouchers for safe delivery to vulnerable and poor pregnant women to access a package of safe delivery services from contracted service providers; and (b) capacity building and project management; under this component the project will support project management functions and build national capacity to mainstream and scale up implementation of the safe delivery voucher scheme in the health sector.

  1. Purpose of this consultancy

The purpose of this consultancy is to document and present one report detailing the how, where and what it entailed to conduct the recently concluded health facility assessments at both private and public facilities by the URHVP team.

  1. Objective of the assignment

The aims of this consultancy are to: 1) Document, edit and proofread the URHVP health facility assessment field reports and synthesize into one report 2) Identify and extract from the draft URHVP health Facility assessment report a step by step guide that can be easily adapted for any similar activities  3. Document, Identify and articulate the lessons learned from the entire activity and suggest the necessary recommendations.

  1. Scope of work

The assignment will involve various tasks, including but not limited to:

  • Conducting interviews with URHVP staff that were directly involved in the HF Assessment. This might involve collecting data form URHVP, District, and Health Workers that directly participated in the assessment. At least one health worker from a district, one staff from the district administration will be interviewed. The interviews need to be carefully planned around what and how exactly the assessment was carried out. In addition, it is highly recommended that the consultant identifies the availability of the members to be interviewed from their respective Districts/work stations to realize full participation of the targeted respondents.
  • Interview with URHVP Program Manager. The study will include gathering qualitative information from the URHVP program manager. In addition to any other persons that might add value to the study such MoH technical teams.

The consultant will be expected to complete the following activities associated with documenting the assessment report:

  1. Ethical Clearance Documentation

The consultant will work in collaboration MSU RME team, to outline all the planned survey activities.  In addition, the consultant/survey firm will be responsible for acquiring all permissions necessary to carry out this assignment. Where required, this may include relevant permissions from national and/or local authorities, and Institutional Review Board.

The consultant will also be responsible for adhering to all necessary formalities aimed at obtaining any relevant permits related to this exercise

6. Deliverables

  • A complete health facility Assessment report
  • A data set for all respondents interviewed
  • A summary of the key step by step guide and how to conduct health facility assessments in the private and public health facilities
  1. Timeframe and fee

The assignment will be remunerated upon delivery of the agreed outputs, at the agreed fee rate and the agreed number of days of professional fess chargeable, as per the normal procedures of MSU. The deadline for completion of the exercise will not exceed 20 days.

  1. Supervision

The consultant will be supervised by the Program Manager, RM&E and the Head Quality Assurance will closely be associated to the discussions with the consultant and review of the draft and final products.

  1. Communication and travel

Costs related to communication should be included in the professional fees. The consultant may be required to travel to the field either at the beginning or at the time of finalizing the deliverables. Transportation should also be included in the financial quotation, basing on the widely known and acceptable rates for hiring vehicles

  1. Required skills/experience and qualifications
  • Minimum 5 years’ experience either through participating health facility assessment or managing health facility-level surveys, experience working on other health-related surveys preferred
  • Demonstrated experience in behavior studies, communication and editing.
  • Strong capacity and experience in planning and organizing survey logistics
  • Strong capacity in data management and statistics.
  • Strong knowledge in any of these software: SPSS or STATA
  • Excellent interpersonal skills and flexible attitude
  1. Proprietary rights

Outputs delivered under this consultancy contract will remain the property of MSU as per MSI’s General Conditions of Contract for Consultants and Individual Contractors.

  1. How to apply

Qualified candidates are requested to email a concept note including the CV to esther.kalule@mariestopes.or.ug and copied to andrew.gidudu@mariestopes.or.ug  deadline for receipt of the application is Wednesday 30th November, 2016 by 4.00 pm.

In your concept note, please indicate relevant experience, availability, estimated number of days to undertake the assignment/budget and your daily rate. Applications submitted without a budget will not be considered. Only shortlisted candidates will be contacted.

Introducing to you our first baby on the URHVP project

Under the voucher HBBH158772, the first project baby has come from Nyakatsiro health Centre III located at Kagorogoro village, Bitereko Sub-county, Mitooma district. This is a private not for profit (PNFP) facility owned and managed by the Catholic Church. The first baby is a girl born on 26/03/2016 at 3:30am, weighing 3.5kgs. Both the mother and the baby are in good condition. Parents of the baby are;
• Nduhukire Racheal 28years (mother)
• Muhumuza Francis 32years (father)
The couple resides in Kagorogoro – Bitereko Sub-county. Nduhukire Racheal has had 5 pregnancies, with 4 children alive. 1 died due to severe malaria, she had an abortion at 8/52.
“We are happy, the voucher has finally come to our rescue. I and my husband were worried how we were going to foot the whole bill of the hospital. We are now thinking of stopping to produce babies for a long time. Thank you very much for the voucher, may God bless you” Nduhukire Racheal

On the same day of 26/03/2016 at 9:00pm, we received a second baby boy from same facility of Nyakasiro HCIII. Born in good condition.
• Birth weight 2.3kgs
• Mother – Nayebare Annet
• Father – Karimu Abdu
The couple comes from Sherere – Kiyanga Sub-county- Mitooma District. This is the first child of this couple.
“We can’t express our joy for this voucher, it has done wonders to us”. Karimu Abdu father of the baby