The document outlines a DFID-funded research program aimed at improving maternal health in Uganda through increased access to institutional deliveries via demand and supply-side interventions. It includes objectives such as assessing the effectiveness of a voucher system for transport and services, as well as identifying factors influencing delivery care. A cluster randomized trial methodology will be employed in selected sub-districts to evaluate the impact of these interventions on maternal health outcomes.

1. Making Health Systems Work for the Poor A DfID funded research programme Collaborating institutions: Uganda - Makerere University Institute of Public Health Nigeria - University of Ibadan Bangladesh - ICDDRB China - Chinese Health Economics Institute India - Indian Institute of Health Management Research Johns Hopkins University, Baltimore, MD, USA Institute of Development Studies, Sussex, UK

2. Making Health Systems Work for the Poor Increasing Access to Institutional Deliveries Using Demand and Supply Side Incentives [Uganda]

3. Aim To contribute in reducing maternal mortality (MDG 5) in Uganda and the regional countries by increasing institutional delivery through an innovative demand and supply side intervention Promote the implementation of evidence based strategies

4. [Uganda]

5. Objectives Identify the demand side factors that influence delivery at health facilities Assess the effectiveness of a voucher system for services and transport in increasing deliveries at public, PNFP and PFP health facilities Assess the effectiveness of a voucher system in increasing deliveries among the poor at public, PNFP and PFP health facilities [Uganda]

6. Objectives Identify the appropriate pathways through which vouchers influence delivery care services at public, PNFP and PFP health facilities Estimate the incremental cost of implementing a voucher system for increasing deliveries at health facilities [Uganda]

7. Methodology Design: Cluster randomized trial Study site: 4 sub-districts (2 intervention and 2 control) will be randomly selected from 2 randomly selected districts in eastern Uganda Intervention: Voucher for transport and maternity services

8. Methodology Primary outcome: % change in the proportion of women delivering in the intervention and control areas Secondary Outcomes: Birth Outcome Attendance of ANC Attendance of PNC Analytical method: Difference in differences analysis

9. [Uganda]

10. Innovations in the project Transport scheme that uses locally available transport Performance based method of payment Inclusion of public and private facilities [Uganda]

11. Actors Makerere University School of Public Health Ministry of Health District health system Donors Health consumer organizations Consumers United Nations agencies Bilateral agencies Politicians Other academic institutions [Uganda]

12. [Uganda]