Reproductive Health Vouchers Improving Women’s Access to Emergency RH Services in the Violence Affected Areas in Syria IAWG Global Meeting February 2015 Dead Sea

Fatima Sufferings

3 Overview: Humanitarian Needs and Response DemandSupply Access? Quality? -Affected people 12.2 million -3 million women of reproductive age -7.6 million Internally Displaced People (IDP) -488,000 pregnant women -300,000 families needs PSS/PFA -34,000 of GBV survivors -Information and awareness raising -RH /GBV services via static and outreach mobile clinics -Basic services/shelters -Implementing partners -UNFPA CO in the region -28 mobile teams -350,000 women received RH/EMOC -118,000 families /women received with PSS/PFA services -140,000 dignity kits -960 relief workers and volunteers were trained on PSS/PFA -18,000 RH vouchers -RH equipment and supplies (RH kits) -Needs assessment of affected people??? -Most vulnerable groups? -Cross line/border operation -Targeting easy to reach people/ places -Resources ??? -Monitoring -Visibility

4 Humanitarian Response Strategies Improve Access to RH and PSS STRATEGY 1: Maintaining the institutional framework for social services, especially health STRATEGY 3: Partnership STRATEGY 5: Outreach Programs ( Hubs and Mobile teams- RH vouchers) STRATEGY 4: Evidence based response STRATEGY 2: Capacity Building ( RHCS and Training)

 Security conditions  “Militarization” of Health care  One health system Vs. Multiple health systems  Economic barriers  Disrupted/ destroyed health facility  Gender considerations  Social norms ( home based delivery Vs. facility based delivery) Challenges hindering Access to RH Services

6 RH Vouchers Security barriers Tool/ mechanism Quality services Free of charge services Cost barriers

RH Voucher Document

 Advocacy of RH Vouchers  Selection of Implementing Partners  Capacity building  Piloting the RH voucher  Demand Based Finance Mechanism  Monitoring Components of Implementation Strategy

Partners of RH Vouchers MOH High Relief Committee Local NGOs Mobile Teams 18- Private Hospitals 4- MoH- MoHE Hospitals Special Award on Partnerships

Evidence Based Revision and Development of the RH voucher System

 18,000 women received services through vouchers  Increase in the use of anti-post natal care, and institutional delivery  RH Vouchers allowed women to choose providers  Improved equitable access to RH services  Better staff and women satisfaction  Less turn over of RH professionals Key Results

 Targeting of population most in need of the RH vouchers  Controlling the overbilling and unnecessary procedures,  Persistent security barriers and difficulties in accessing health facilities  Difficulty to monitor private sector hospitals  Confusion that the vouchers are designed only for delivery  Resources Challenges

 The RH voucher program reduced the delays to RH services at the community and institution services  The RH voucher acted as a catalyst for improvements of quality of maternity care in both public and private sectors health facilities,  Importance of entering into partnership with local and international  Third party monitoring of the RH voucher is key for system improvement and accountability. Lessons Learnt

Thank You 14