2. Defining Output-Based Aid (OBA)
A performance-based subsidy that is payable on the
achievement of measureable results.
Services contracted out to a third party (service
provider, which can be a private or public service entity)
Service providers are - for the most part - reimbursed
after delivery of the (pre-) agreed output
Subsidy funding generally from public sources
2
3. The HealthyBaby Concept
For women identified as poor
• A voucher, offering her:
– 4 antenatal visits
– Transport to a health facility
for delivery (NEW)
– A safe delivery, regardless of
how complicated
– Transportation between
facilities in case of referral
– Postnatal care
• All in a private facility where
the quality is ensured and
monitored
4. Previous Programme
•Funded by the World Bank
(GPOBA) and KfW and
implemented in partnership with
the MoH
•Over 100,000 vouchers sold
•Over 60,000 babies safely
delivered
•Over 80,000 women received ANC
•Allowed many providers to invest
in their facilities
5. Impact
• Reduced the cost barrier facing women seeking
maternal health services
• Improved knowledge of danger signs in pregnancy /
childbirth and of STI’s among women who are exposed
to the voucher programme
• Reduced socio economic inequity in service utilization
No voucher user present in
village Voucher user present in village
100 100
90
80 80
63 70
58
68
60 54 60 55
44 50
49
40 35 40
30
20 20
10
0 0
4+ ANC visits Facility delivery 4+ ANC visits Facility delivery
Poorest 40% Least poor 40%
Poorest 40% Least poor 40%
6. Impact (2)
• Increased satisfaction with services – 98% of voucher
clients were satisfied with the services they
received, as opposed to 76% of non voucher clients
• Increased utilization of safe motherhood services by
poor women exposed to the programme
• Even among poor women, the very poorest were the
ones most likely to use the voucher
No voucher user present in Voucher user present in
100
100
village village
80
80
58 62
56 60 53 55
60
46 46 48 41 45
40
37 39 40
20 20
0 0
4+ ANC visits Facility delivery Postnatal care 4+ ANC visits Facility delivery Postnatal care
Before program During program Before program During program
Editor's Notes
Emphasise these are from Population Council Report
