Third Party Payer E-Vouchers Program
We have developed a phone based technology that enables needy individuals receive e-vouchers by phone. This technology has been used to pilot a maternal healthcare project in Vihiga Western Kenya.
Saving lives at birth; maternal healthcare subsidy programme in Vihiga Western Kenya using e-vouchers.
The Saving Lives at Birth subsidy program was designed to promote healthy birthing practices western Kenya. The Vihiga District was selected as the ideal location for this program because cost of care and lack of access to information and transportation have been identified as key barriers to hospital deliveries.
Currently across Kenya and especially in impoverished, rural locations such as Vihiga, few women have access to proper ante and postnatal care. Additionally, on average only 44% of births are attended by trained health professionals. In Vihiga the discrepancy is even more stark where only 26% of births occur in a medical facility. As a result of these practices, maternal and infant mortality rates are very high (488 in 100,000 live births) as infants and mothers are often faceserious complications such as postpartum hemorrhaging and preeclampsia, which if left untreated can result in death.
Using smart phones, trained community health workers enroll expectant mothers in the Saving Lives at Birth Program, enabling women from the District to gain access to free or subsidized ante and postnatal visits, delivery services and transportation to medical facilities. This two-year program is funded by Saving Lives at Birth, a consortium of multinational NGOs including USAID, The Bill & Melinda Gates Foundation and Grand Challenges Canada. Each participating member of the Consortium is dedicated to reducing the infant and maternal mortality rate and helping Kenya to meet Millennium Development Goal 5.
Changamka has implemented an innovative system in Vihiga called M-KADI whereby health vouchers and subsidies are distributed electronically to program participants via their mobile phones. Women will then use the funds stored on their M-KADI to access care.
By leveraging an electronic platform, Changamka also has the ability to conduct SMS messaging campaigns aimed at education women about the benefits of hospital-based delivery and reminding them about upcoming appointments. This program also promotes transparency and accountability, enabling donors to know exactly how their funds are spent.
Working with the Kenyan Ministry of Health and Sanitation, this program has been adopted at all public hospitals in the District, both increasing convenience and giving women a choice about where they seek care. Further, computers have been installed at each location to facilitate electronic payments and support a research study conducted by Georgetown University to determine whether certain variables and incentives are effective in encouraging behavioral change and promoting positive health outcomes.
Nearly 1,700 women across the Vihigia District have enrolled in the Saving Lives at Birth program since it began in January 2013. The patient population ranges from age 15-47 and the program has enrolled both first time mothers and those who have experienced complicated pregnancies in the past. Collectively, there have been more than 112 safe deliveries at participating facilities including 11 births by caesarian.
Our data also indicates a substantial improvement in the number of women who seek both antenatal and postnatal care to protect their health and that of their babies. The success of this program demonstrates that communities welcome programs that raise health education and provide its constituents with access to affordable, quality care.
Participants in the saving lives at birth program are eligible to receive;
• 4 non-specialist antenatal care visits including maternity profiling
• Delivery (natural& caesarian sections) and emergency referral transportation to Vihiga District Hospital if deemed necessary
• 3 non-specialist Postnatal care visits up to 6 weeks after delivery