Vouchers for Health: Increasing Utilization of Facility-Based STI and Safe Motherhood Services in Uganda

Ben Bellows and Matthew Hamilton

This case study shares the experience of Uganda using vouchers to stimulate uptake of services for sexually transmitted infections (STIs) and safe deliveries. P4P was first introduced to increase treatment of sexually transmitted infections (STIs); later a safe motherhood component was added to augment the number of facility-based deliveries. Specific vulnerable groups are targeted and receive subsidized vouchers, which they can use to access services at accredited private clinics. Findings reveal that STI symptom knowledge increased and that the reduction in syphilis prevalence was greater among respondents who lived closer to contracted private facilities. Yet STI treatment utilization did not increase significantly and the program experienced a handful of challenges (for example, with claims management). This case study provides an example of how a Government can regulate the private health sector through use of financial incentives and offers lessons for countries wishing to expand service access to safe motherhood and STI treatment through P4P engagement of private sector providers.

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