First HealthyBaby birth
The first delivery on the new HealthyBaby vouchers took place the morning of February 28th (see Melissa’s post).The delivery took place at Angella’s Domicillary in Rubindi trading center. Mother and baby are both doing well.
The program was launched in September in Mbarara and then issues ranging from reimbursement rates to database development took longer to resolve than initially anticipated, but the program is up and running now. It’s being rolled out in two stages. 11 facilities in the areas within an hour’s drive of Mbarara town are contracted now and 15 voucher community-based distributors do door-to-door selling of vouchers to poor women in rural communities. By May a second phase of 60 providers and many new voucher distributors will be confirmed in districts to the north and west - up to four hours from Mbarara in some cases. In the end, a population of 7-8 million will be covered with an anticipated 110,000 deliveries in the next three years.
In the HealthyBaby program the mother purchases a voucher for 3000 USh (approximately 1.50 USD). A peal-off sticker from the voucher is then submitted with a claim form on each visit. Four antenatal visits are covered by the program as well as the delivery, including any surgery needed then, and postnatal care.
After each visit, the facility submits the claim form with the voucher to the management agency, Marie Stopes International Uganda, which then pays the hospital for the cost of the visit - labs, any prescriptions given, the consultation fee, etc. The attending nurse usually completes the paper form and the mother signs or puts her thumbprint on it. Filling out the forms can be tedious and error prone. The same seems to be true too of much of the government clinic data reported to district health offices and up to the Ministry of Health in Kampala. Record keeping can be improved. Melissa is working to develop digital systems that can help improve communications between the clinics and the management agency, and also decrease the cost and burden of claims administration. More on that later.