STRIDES for Family Health was funded by the US Agency for International Development (USAID) and led by Management Sciences for Health (MSH), which partnered with the Communication for Development Foundation Uganda (CDFU), Jhpiego, and Meridian Group International. STRIDES began working in 2009 to reduce fertility, morbidity, and mortality rates among Ugandan women and their families. By expanding access, improving quality, increasing demand, and promoting integration of health services at the facility and community level in the public and private sector, STRIDES made a number of notable achievements in its six years of operation in 15 districts of Uganda. The project served 15 percent of Uganda’s population, or about 5.4 million people, 1 million of whom were children under the age of five.
St. John’s Hospital in Kyenjojo district, received a PBC to mobilize mothers to access free ANC and comprehensive emergency obstetric and newborn care services through a voucher scheme. “We learned a lot about how to engage the community in health service delivery,” said Dr. David Mwinganiza, St. John’s Hospital director. “The program was community-based and the community embraced it. And we learned a lot how, as a facility, to improve our skills and capacity to handle any sort of services.”
Pregnant women were encouraged to complete the standard four ANC consultations, as recommended by the World Health Organization, to be eligible to receive the other free health services. Mothers who completed the fourth visit received a green voucher that entitled them to access free services, such as ultrasound scanning, cesarean sections, lab tests, postnatal care, and postabortion care. This significantly increased the number of women who accessed these services. Before the voucher program started in 2012, the number of pregnant women attending their fourth ANC consultation in the district was 34 percent, Dr. Mwinganiza said. That figure rose to 61 percent by June 2013.