1 Uganda Voucher Plus Activity Quarterly Report Year 4, Quarter 4 July – September 2019 Re-submission date: 4 November 2019 Submission Date: 31 October 2019 Number: AID-617-LA-16-00001 Activity Start Date and End Date: January 29, 2016 to September 30, 2020 Name: Dr. Christine Mugasha Submitted by: Christine Namayanja, Chief of Party Abt Associates 6130 Executive Boulevard Rockville, MD 20850, USA Tel: +1-301-347-5000 Email: [email protected] Copied to: [email protected] This document was produced for review by the United States Agency for International Development Uganda USAID|Uganda Mission (USAID/Voucher PlusUganda Activity). Contents Acronyms and Abbreviations .......................................................................................................... iii Activity Information .......................................................................................................................... iv 1. Activity Introduction ................................................................................................................ 1 1.1 Activity Description ................................................................................................................................ 1 1.2 Performance Analysis to Date .............................................................................................................. 2 2. Activity Implementation Progress ......................................................................................... 6 2.1 Summary of Implementation Status .................................................................................................... 6 2.2 Progress Narrative .................................................................................................................................. 7 3. Guiding Principles ................................................................................................................... 11 3.1 Partnership, Collaboration, and Stakeholder Engagement .......................................................... 11 3.2 Inclusive Development ......................................................................................................................... 12 3.3 Learning and Adaptation ...................................................................................................................... 12 4. Leadership and Development .............................................................................................. 12 5. How has Activity Addressed AOR Feedback from Last QR? ...................................... 12 6. Summary Financial Management Report ........................................................................... 13 7. Management and Administrative Issues ............................................................................. 13 7.1 Key Management Issues ....................................................................................................................... 13 7.2 Resolved Management Issues.............................................................................................................. 16 8. Planned Activities for Next Quarter Including upcoming Events ................................ 16 9. Annexes .................................................................................................................................... 18 9.1 Activity Work Plan ................................................................................................................................ 18 9.2 Special Reporting Requirements ........................................................................................................ 25 9.3 Success Stories ....................................................................................................................................... 32 9.4 Stakeholder Engagement to Foster Collaboration, Coordination, and Adaptive Management ................................................................................................................................................................... 35 9.5 Updated Learning Agenda Schedule .................................................................................................. 38 USAID|Uganda Voucher Plus Activity i Table 1. PMP/Project Indicator Progress..................................................................................................... 2 Table 2. Y4Q3 Activity Implementation Status .......................................................................................... 6 Table 3. Y4Q3 Financial Report ................................................................................................................. 13 Table 4. Summary of recoveries from VSPs during Q4 .............. Error! Bookmark not defined. Table 5. Y5Q1 Planned Activities .................................................... Error! Bookmark not defined. Figure 1. Total monthly VSP reimbursements January 1, 2017 to September 30, 2019 ............... 15 Figure 2. Avg monthly claims turn-around time (days) November 2016 to September 2019 ..... 15 USAID|Uganda Voucher Plus Activity ACRONYMS AND ABBREVIATIONS ADHO Assistant District Health Officer AMELP Activity Monitoring and Evaluation Plan ANC Antenatal Care ART Antiretroviral Therapy BEmONC Basic Emergency Obstetric and Newborn Care CEMONC Comprehensive Emergency Obstetric and Newborn Care CME Continuing Medical Education DHIS District Health Information System DHO District Health Office DHT District Health Team EDHMT Extended District Health Management Team EMTCT Elimination of Mother-to-Child Transmission EOP End of Project FP Family Planning HC Health Center HIV Human Immunodeficiency Virus HMIS Health Management Information System HPU Health Partners Uganda IP Implementing Partner IR Intermediate Result K&L Knowledge and Learning MCH Maternal and Child Health MNCH Maternal, Newborn, and Child Health MOH Ministry of Health MPDSR Maternal and Perinatal Death Surveillance and Response OBA Output-Based Aid PNC Postnatal Care PPFP Postpartum Family Planning PPPH Public-Private Partnerships for Health QI Quality Improvement RBF Results-based Financing RHITES Regional Health Integration to Enhance Services RMNCH Reproductive, Maternal, Newborn, and Child Health SBCC Social and Behavior Change Communication SBCCO Social and Behavior Change Communications Officer SGBV Sexual and Gender-Based Violence TBA Traditional Birth Attendant UDHS Uganda Demographic and Health Survey UGX Ugandan shilling USAID United States Agency for International Development USD United States Dollar USG United States Government VCBD Voucher Community-Based Distributor VHT Village Health Team VMA Voucher Management Agency VSP Voucher Service Provider VSLA Village Savings and Loan Association USAID|Uganda Voucher Plus Activity ACTIVITY INFORMATION Activity Name: Uganda Voucher Plus Activity Project: The Voucher Plus Activity is a five-year (2016–2021) project of the United States Agency for International Development (USAID) that aims to increase use of health services for pregnant women by promoting safe, facility-based deliveries among poor women to reduce maternal and neonatal morbidity and mortality in Eastern and Northern Uganda. Activity Start Date and End January 29, 2016–September 30, 2020 Date: Name of Prime Abt Associates Implementing Partner: [Contract/Agreement] AID-617-LA-16-00001 Number: $24,499,611 Name of Sub-awardees and Communication for Development Foundation Uganda – UGX Dollar Amounts: 5,913,526,140 (approx. 1,845,670 United States Dollars (USD)) PricewaterhouseCoopers–UGX 10,148,838,667 (approx. USD 2,899,668) Plus provider reimbursement UGX 29,520,000,000 (approx. USD 9,000,000). BDO Uganda–UGX 2,913,532,719 (approx. USD 859,789). Major Counterpart Ministry of Health (MOH), District Health Management Teams (DHMTs), Organizations: World Bank (WB), Marie Stopes Uganda (MSU), Regional Health Integration to Enhance Services (RHITES), implementing partners (IPs), and Communication for Healthy Communities (CHC) Geographic Coverage Agago, Alebtong, Amuria, Amuru, Apac, Budaka, Bulambuli, Bukedea, (districts; also, note any Butebo, Butaleja, Dokolo, Gulu, Kaberamaido, Kapchorwa, Katakwi, changes): Kitgum, Kole, Kumi, Lamwo, Lira, Manafwa, Mbale, Ngora, Nwoya, Omoro, Otuke, Oyam, Pader, Pallisa, Serere, Sironko, Soroti, Namisindwa, Kwania and Kapelebyong. Reporting Period: July 1– September 30, 2019 USAID|Uganda Voucher Plus Activity 1. ACTIVITY INTRODUCTION 1.1 Activity Description The Uganda Voucher Plus Activity (the Activity), led by Abt Associates, provides quality obstetric, newborn, and postpartum family planning services to very poor Ugandan women in the North and East. Ultimately, the Activity improves health equity by ensuring the poor in 35 districts have access to information and services to support healthy pregnancies and deliveries. To do so, the Activity identifies and accredits private providers to deliver a package of services, for which the providers are reimbursed by the Activity. Simultaneously, the Activity works with community volunteers, including Village Health Teams, who sell vouchers at 4,000 Ugandan shillings (UGX) to women who qualify, while also providing safe motherhood information to target populations. The voucher service package includes four antenatal care (ANC) visits; elimination of mother-to-child transmission of HIV services (EMTCT); delivery with a skilled birth attendant and referral for complications, postnatal care, and postpartum family planning (PPFP). By targeting