1. To reduce inequities in reproductive health care by enabling access to services, while empowering the below poverty line (BPL) population to choose their own providers The Voucher System Demand-side Financing IFPS II Technical Assistance Project (ITAP)

2. Voucher Management System Voucher Management Agency Voucher Redemption Private Nursing Homes Voucher Redemption BPL Families Voucher Distribution ASHA Voucher Distribution ANM Voucher Distribution Payment for Services Payment for Services

3. The Voucher System Provided high-quality private sector services at deep discount rates Expanded services cost-effectively even with under-staffing at government facilities Relieved pressure on government Enabled clients to save money Photos by Suneeta Sharma (top) and Simply CVR (bottom) Some Highlights

4. Improving Access Use of Institutional Delivery Services Endline 2009 Baseline 2007 Use of Institutional Delivery Services (%)

5. Improving Access Use of Modern Contraceptives Endline 2009 Baseline 2007 Use of Modern Contraceptives (%)

6. Udham Singh Nagar Naintal Almora Dehradun Haridwar Bahadrabad Imlikheda Sustainable Financing and Scaling Up Total population coverage in pilot: 0.15 million Total population coverage in scale up: approx. 5.36 million Total population coverage in pilot: 0.15 million Total population coverage in scale up: approx. 5.36 million USAID contribution in demonstration: USD 170,666 for 12 months GoUK funds for scale up: USD 1,045,000 for 12 months USAID contribution in demonstration: USD 170,666 for 12 months GoUK funds for scale up: USD 1,045,000 for 12 months The Voucher Scheme in Uttarakhand, India

7. POLICY PAYS OFF Building Foundations for Sustainable Health Programs Mobile Health Clinic: Reaching the Underserved in Uttarakhand A fixed day, fixed time, and fixed place approach to provide primary healthcare services in remote rural areas

8. Jamrani 18 km 25 km Chorgalia 25 km Bindukhatta HALDWANI Maldhanchour 33 km Thari Amgarhi Kotabagh Kamola Dhamola 20 km 25 km 35 km 25 km BHIMTAL- BISR 30 km 60 km RAMNAGAR Total 8 sites Visit every 15 days Camps in a month 16 Route Map of Mobile Health Clinic

9. Performance Statistics (JAN 09 – DEC 09) 195 Camps held 11,352 out-patients registered Average patients per camp – 59.1 IUD insertions – 189 Pills distributed – 1,292 cycles Condoms distributed (packs of 10)– 411,00 pieces

10. Scaling up Mobile Health Clinic Coverage & Funding Total population coverage in pilot: 0.5 million Total population coverage in scale up: 10 million Total population coverage in pilot: 0.5 million Total population coverage in scale up: 10 million USAID contribution in demonstration: Capital Costs: Nil Operating Costs: USD 186,000 GoUK funds for scale up: Capital costs: USD 1.97 million Operating Costs: USD 580,000 USAID contribution in demonstration: Capital Costs: Nil Operating Costs: USD 186,000 GoUK funds for scale up: Capital costs: USD 1.97 million Operating Costs: USD 580,000