Do Transport Vouchers Using Locally Available Means Increase Attended Deliveries? A Case Study of a Rural Community In Uganda

Presenter: Aloysius Mutebi, Makerere University School of Public Health

Background: In Uganda, only 37 per cent of mothers have a skilled attendant at delivery, and only 6 per cent of babies born at home get post-natal care. There is an unacceptably high maternal mortality ratio (MMR) for Uganda of 435 per 100,000 Live Births (UDHS 2006) from 505 per 100,000 Live Births (UDHS 2001) and 506 per 100,000 Live Births (1995).  The objectives of this study sought to increase attended deliveries using a transport voucher to provide free transport to pregnant women going to deliver in both government and private not for profit health units in the intervention area in Pallisa district.

Methodology: This study was a quasi-experimental trial in 2 rural health sub districts of Pallisa district. There was an intervention and control area in this district. The transport voucher was only distributed in the intervention area. There were 8 health units in the intervention area and 12 health units in the control area.

Results:  The number of women delivering in health facilities more than doubled since the inception of the study in June 2010. On average all health units in the intervention area witnessed a tremendous increase in number of deliveries and the health workers attributed this increase to the free transport offered using the transport vouchers.

Conclusion: Using locally available transport providers was key to improving access to health services provided using trained personnel. If funds can be availed the transport voucher scheme is highly recommended for adaption by other districts to increase attended deliveries.