Providing Safe Delivery Services With Vouchers: The Reproductive Healthcare Voucher Project in Western and Southern Uganda 

Healthcare-and specifically maternal healthcare-is undoubtedly vital to the alleviation of poverty. The development community paid significant attention to healthcare by devoting three of its eight Millennium Development Goals (MDGs) to healthcare with two of the three MDG healthcare goals dedicated to child mortality and maternal health Clearly, the MDGs, especially the eradication of extreme poverty and hunger, cannot be achieved if population and reproductive health issues are not addressed. Uganda – where the average woman undergoes seven pregnancies – has the second highest fertility rate in the world. Maternal and perinatal health conditions account for 20.4% of the total disease burden in the country. The World Bank Group and the Global Partnership on Output-Based Aid (GPOBA) managed and helped fund this large scale project in western and southern Uganda. The Reproductive Healthcare Vouchers Project (RHVP) provided subsidized vouchers to women for a package of birthing services at clinics, services supplied by skilled medical practitioners. It also provided subsidized vouchers to couples for HIV/AIDS and other sexually transmitted diseases. This SmartLesson, in describing the project’s outcomes also highlights some key lessons learned as vouchers were introduced for the first time in a health care context in the World Bank’s Africa region.