Implementing e-Vouchers to improve the utilization of FP services: Marie Stopes International Ethiopia BlueStar Program Authors: Andinet Bayissa, Abebe Shibru October 2014 Cebu

Background & Overview Contraceptive prevalence among married women: 42%. (EDHS, 2014) Women of reproductive age group constitute 23.4% of the total population Total Fertility rate: 4.1 (EDHS, 2014) Unmet need for Family planning: 25% (EDHS, 2011)

Private Health Sector in Ethiopia More than 5,100 private health facilities in Ethiopia Public sector is a major source of contraception [82%] while private sector is only 13.4% The Private health Sector contribution for family planning service is not more than 13%. 44% of National Health Expenditure (NHE) is from the Private Health Sector.

Aim of the MSIE eVocuher: Removing economic barrier of poor women for FP service through implementing e-vouchers in BlueStar program To take advantage of the rapid growth of mobile phone ownership among the rural community to increase the efficiency and scalability of voucher programmes.

Methods Launched in 25 sites in the BlueStar network, these sites are located in 25 rural & semi-urban parts of the country. It was designed to increase the uptake of IUD, which is the least utilized method in Ethiopia, particularly among youth, who have the highest unmet need for family planning. Smart phones is used to issue vouchers, while short message service (SMS) is used by the provider to validate and redeem the eVouchers. Data routinely collected: Distribution & redemption of voucher, profile of clients, FP service data the voucher redeemed for.

Findings & Results In the first eight weeks of implementation 1,378 e-vouchers issued to beneficiaries. 77% users were between the ages of 15-29; and the redemption rate was 48%. The majority clients received IUCD with 44% uptake rate followed by 28% implant and 21% injectable The average IUD insertion by the BlueStar clinics before the launch of eVouchers was 5 per month. After the launch of the E-voucher the insertion of IUD increased into 97 per month.

Show case: redemptions trend b/n MSIE Clinics & BS clinics eVoucher

Challenges encountered & action taken Low redemptions by some of the BlueStar Clinics. No reporting of malfunction or system problem Misuse of phone by CHWs resulting in changes in settings or deletion of eVoucher application Frequent system interruption due to network failure

Lessons & importance of the findings e-Voucher can have an impact on increasing the unutilized FP services such as IUCD in BlueStar clinics, especially among youth groups.

Way forward Scaling up the implementation of eVoucher in 100 BlueStar clinics after evaluating the first phase of implementation Sharing the experience to local partners to replicate the system for other applicable health programs in the country

Thank You !