1 Uganda Voucher Plus Activity Quarterly Report Year 4, Quarter 1 October – December 2018 Submission Date: 31 January 2019 Name: Dr. Christine Mugasha Number: AID-617-LA-16-00001 Activity Start Date and End Date: January 29, 2016 to January 28, 2021 Submitted by: Christine Namayanja, Chief of Party Abt Associates Plot 86 Luthuli Avenue Bugolobi P.O.Box 37443 Kampala Uganda Office: +256 414 223546 | +256 312 305900 Email: [email protected] Copied to: [email protected] This document was produced for review by the United States Agency for International Development Uganda Mission (USAID/Uganda). USAID|Uganda Voucher Plus Activity 1 1 Acronyms and Abbreviations .................................................................................. iii Activity Information ................................................................................................... v 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 .................................................................................................................................. 8 3. Guiding Principles ........................................................................................... 11 3.1 Partnership, Collaboration, and Stakeholder Engagement .......................................................... 11 3.2 Learning and Adaptation ...................................................................................................................... 12 3.3 Inclusive Development ......................................................................................................................... 13 4. Leadership and Development ...................................................................... 13 5. How has Activity Addressed AOR Feedback from Last QR? ............... 13 6. Summary Financial Management Report .................................................... 14 7. Management and Administrative Issues ..................................................... 15 7.1 Key Management Issues ....................................................................................................................... 15 7.2 Resolved Management Issues.............................................................................................................. 16 8. Planned Activities for Next Quarter Including upcoming Events ......... 17 9. Annexes ............................................................................................................ 18 9.1 Activity Work Plan ................................................................................................................................ 18 9.2 Special Reporting Requirements ........................................................................................................ 25 Health .................................................................................................................................................................. 25 9.3 Success Stories ....................................................................................................................................... 31 9.4 Stakeholder Engagement to Foster Collaboration, Coordination, and Adaptive Management ................................................................................................................................................................... 34 9.5 Activity Learnings and Adaptions in Past Periods .......................................................................... 37 9.6 Updated Learning Agenda Schedule .................................................................................................. 40 USAID|Uganda Voucher Plus Activity ii ACRONYMS AND ABBREVIATIONS ADHO Assistant district health officer AMELP Activity Monitoring, Evaluation, and Learning Plan ANC Antenatal care ANC4 Four antenatal care visits ART Antiretroviral therapy BEmONC Basic emergency obstetric and newborn care CDCS Country Development Cooperation Strategy CEMONC Comprehensive emergency obstetric and newborn care CHC Communication for Healthy Communities CHI Community health insurance CHW Community health worker CME Continuing medical education DHIS District Health Information System DHO District Health Office DHIS2 District Health Information System 2 DHMT District Health Management Team 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 IEC Information, education, and communication IP Implementing partner IPT Intermittent preventive treatment IR Intermediate result IVEA Independent Verification and Evaluation Agency K&L Knowledge and learning MCH Maternal and child health MHealth Mobile health MNCH Maternal, neonatal, and child health MOH Ministry of Health MPDSR Maternal and perinatal death surveillance and response MTCT Mother-to-child transmission OBA Output-based aid OIG Office of Inspector General PNC Postnatal care PPFP Postpartum family planning PPPH Public-private partnerships for health PRS Performance Reporting System QI Quality improvement RBF Results-based financing RHITES Regional Health Integration to Enhance Services RMNCH Reproductive, maternal, neonatal, and child health SBCC Social and behavior change communications SBCCO Social and behavior change communications officer USAID|Uganda Voucher Plus Activity iii iii SDA Safari Day Allowance SGBV Sexual and gender-based violence SQIS Self-Regulatory Quality Improvement System TBA Traditional birth attendant UDHS Uganda Demographic and Health Survey UGX Ugandan shilling UHF Uganda Healthcare Federation URMCHIP Uganda Reproductive, Maternal, and Child Health Services Improvement Project USAID United States Agency for International Development USD United States dollar USG United States Government UTI Urinary tract infection UWOPA Uganda Women Parliamentarians Association VCBD Voucher community-based distributor VHT Village Health Team VMA Voucher Management Agency VMIS Voucher management information system VSLA Village savings and loan association VSP Voucher service provider USAID|Uganda Voucher Plus Activity iv iv ACTIVITY INFORMATION Activity Name: Uganda Voucher Plus Activity Project: The Voucher Plus Activity is a five-year (2016–2021) project of 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–January 28, 2021 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. USD1,845,670) 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: October 1, 2018 – December 31, 2018 USAID|Uganda Voucher Plus Activity v v 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 (PPFP) services to very poor Ugandan women in the North and East. The Activity improves health equity by ensuring the poor in 35 districts have access to information and services for healthy pregnancies and deliveries. 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 local populations. The voucher service package includes four antenatal care (ANC) visits; elimination of mother-to-child transmission (EMTCT) of HIV services; delivery with a skilled birth attendant and referral for complications, postnatal care, and postpartum family planning. By targeting very poor women to receive the voucher, the Activity seeks to provide