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Understanding the Incremental cost of Increasing Access to Maternal Health Care Services: Perspectives from a Voucher Scheme in Eastern Uganda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[Uganda]
Introduction ,[object Object],[object Object],[object Object]
Introduction  ,[object Object],[object Object],[object Object],[Uganda]
Introduction  ,[object Object],[object Object],[Uganda]
AIM ,[object Object],[object Object]
Voucher Scheme package ,[object Object],[object Object],[Uganda]
Voucher scheme package ,[object Object],[object Object],[Uganda]
Cost price of Health Services(USD) [Uganda] Service Pilot Phase (De’9-may’10) Implementation(ju’10-fe’11) Implementation (mar’11-de’11) Gv’t PNFP Gv’t PNFP Gv’t PNFP ANC1 0.9 1.14 0.4 0.55 0.4 0.55 A2,3,4 1.0 1.36 0.4 0.55 0.4 0.55 DEL 5.1 6.82 2.7 3.64 4.1 5.45 C/S 51.1 68.18 29.5 59.09 27.3 54.55 PNC 1.0 1.36 0.4 0.55 0.5 0.55
Methodology ,[object Object],[object Object],[object Object],[Uganda]
Cost Categories [Uganda] COST CATEGORY DESCRIPTION Voucher costs Transport and service voucher reimbursements, voucher printing, distribution, and transporters’ identification prints(cards) H. S. Strengthening Health workers’ trainings, procurements of basic equipment, drugs and supplies and regular support supervisions. Sensitization &mobilization Stakeholder workshops at community, facility and district levels, talk shows and radio messaging, printing of posters production of documentary, hire of film vans, etc. Administrative costs Costs relating to personnel, field coordination, field supervision, planning activities, regular scheme reviews by faculty, etc..
Methodology ,[object Object],[object Object],[object Object],[Uganda]
Results: Summary costs on voucher reimbursement [Uganda] Activity Amount (Ug. Shs) Amount (USD) Total cost Service Vouchers 87,680 95,866 Admin costs for payment 4135 Contingencies 241 Printing vouchers 3809.8 Transport vouchers 174,666.08 185,376 Admin costs 4793 Contingency 482.85 Printing vouchers 3809.8 Printing Identification cards 1622
Results: Summary costs on Health System Strengthening [Uganda] Activity Amount(USD) Equipment , drugs, sundries 101,822 Support Supervision 13,917 Training of Health Workers 8,973 Training materials 616 Total 125,328
Results: Summary Distribution of costs by major activity(Percentage Distribution) [Uganda] Activity Amount(USD) Percentage Service voucher costs 95,866 19.1 Transport Voucher costs 185,376 36.9 Health Systems Strengthening 125,328 24.9 Sensitization and mobilization 46,396 9.2 Administration 49,869 9.9 Total 502,835 100.00
Graph showing share of key-scheme activity costs as % of total costs [Uganda]
Service vouchers reimbursed in intervention period [Uganda] Service Total Percentage of total ANCs 6302 15.9 Delivery 22558 57.0 PNC 9678 24.4 C-Section 213 0.5 False Labour 810 2.0
Results [Uganda] Total cost transport vouchers ( excluding referral transport) No of women transported Cost per woman transported $183,439 39,348 $4.6
Results [Uganda] Incremental cost for deliveries Additional deliveries Incremental cost per  additional institutional  delivery $304,248 19,288 $15.7 Incremental cost for PNC’s Additional PNC visits Incremental cost per  additional PNC $102,352 7452 $13.73
Conclusion  ,[object Object],[object Object],[object Object],[Uganda]
Policy Implication ,[object Object],[object Object],[Uganda]

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Incremental Costs of Voucher Scheme - Chrispus Mayora

  • 1.
  • 2.
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  • 4.
  • 5.
  • 6.
  • 7.
  • 8. Cost price of Health Services(USD) [Uganda] Service Pilot Phase (De’9-may’10) Implementation(ju’10-fe’11) Implementation (mar’11-de’11) Gv’t PNFP Gv’t PNFP Gv’t PNFP ANC1 0.9 1.14 0.4 0.55 0.4 0.55 A2,3,4 1.0 1.36 0.4 0.55 0.4 0.55 DEL 5.1 6.82 2.7 3.64 4.1 5.45 C/S 51.1 68.18 29.5 59.09 27.3 54.55 PNC 1.0 1.36 0.4 0.55 0.5 0.55
  • 9.
  • 10. Cost Categories [Uganda] COST CATEGORY DESCRIPTION Voucher costs Transport and service voucher reimbursements, voucher printing, distribution, and transporters’ identification prints(cards) H. S. Strengthening Health workers’ trainings, procurements of basic equipment, drugs and supplies and regular support supervisions. Sensitization &mobilization Stakeholder workshops at community, facility and district levels, talk shows and radio messaging, printing of posters production of documentary, hire of film vans, etc. Administrative costs Costs relating to personnel, field coordination, field supervision, planning activities, regular scheme reviews by faculty, etc..
  • 11.
  • 12. Results: Summary costs on voucher reimbursement [Uganda] Activity Amount (Ug. Shs) Amount (USD) Total cost Service Vouchers 87,680 95,866 Admin costs for payment 4135 Contingencies 241 Printing vouchers 3809.8 Transport vouchers 174,666.08 185,376 Admin costs 4793 Contingency 482.85 Printing vouchers 3809.8 Printing Identification cards 1622
  • 13. Results: Summary costs on Health System Strengthening [Uganda] Activity Amount(USD) Equipment , drugs, sundries 101,822 Support Supervision 13,917 Training of Health Workers 8,973 Training materials 616 Total 125,328
  • 14. Results: Summary Distribution of costs by major activity(Percentage Distribution) [Uganda] Activity Amount(USD) Percentage Service voucher costs 95,866 19.1 Transport Voucher costs 185,376 36.9 Health Systems Strengthening 125,328 24.9 Sensitization and mobilization 46,396 9.2 Administration 49,869 9.9 Total 502,835 100.00
  • 15. Graph showing share of key-scheme activity costs as % of total costs [Uganda]
  • 16. Service vouchers reimbursed in intervention period [Uganda] Service Total Percentage of total ANCs 6302 15.9 Delivery 22558 57.0 PNC 9678 24.4 C-Section 213 0.5 False Labour 810 2.0
  • 17. Results [Uganda] Total cost transport vouchers ( excluding referral transport) No of women transported Cost per woman transported $183,439 39,348 $4.6
  • 18. Results [Uganda] Incremental cost for deliveries Additional deliveries Incremental cost per additional institutional delivery $304,248 19,288 $15.7 Incremental cost for PNC’s Additional PNC visits Incremental cost per additional PNC $102,352 7452 $13.73
  • 19.
  • 20.