Urban and Rural Voucher Systems

Each year, millions of pregnant women give birth without access to proper health care services. Countries such as Ethiopia, Laos and Yemen are just a few parts of the world where this is a major problem. For example, in Ethiopia, 59 percent of women do not receive care by a medical professional during pregnancy. In Zimbabwe, however, access to prenatal care has drastically improved since the 2014 implementation of the Urban and Rural Voucher Systems (UVS and RVS, respectively). These systems allow for low-income pregnant women to receive the healthcare that they need. They have already had incredible benefits on thousands of pregnant women. Additionally, they set a great precedent for governments and NGOs to come together to find solutions to pressing maternal health issues.


The UVS and RVS service pregnant women whose incomes place them in the bottom 40 percent of households in Zimbabwe. Consequently, women who cannot afford the required $25 co-pay at many clinics can still receive care. Providing women with this essential health care helps to ensure that these women and their babies stay healthy and safe both during and after pregnancy.


The government of Zimbabwe, the World Bank and Codaid are the main sources of funding for the UVS and RVS. Cordaid is a local NGO that has assisted with much of the program’s implementation. Clinics are subsidized based on their performance. They measure performance on overall range and quality of coverage. This supply-side solution works to help promote jobs and economic growth in local communities, which contributes to the program’s long-term sustainability.

Impact on the Poor

Access to proper care during pregnancy is essential to ensure the health of expectant mothers and their child. In many countries around the world, women do not have access to this care. As a result, the consequences have been horrific.

For instance, there are roughly 3.3 million neonatal deaths recorded per year. Neonatal refers to the first four weeks of a baby’s life. Proper prenatal care can prevent these fatalities. A woman who receives such care is far less likely to give birth to a child with fatal health issues. Proper prenatal care can help identify and fix possible health issues before they become too serious. In addition, receiving prenatal care can offer educational resources. The care can educate a woman about the ways in which they should go about raising a healthy child.


Zimbabwe’s Urban and Rural Voucher Systems have had immense benefits since their implementation. The thousands of women that they have helped to serve reflect such benefits. The programs provide an affordable and accessible option for pregnant mothers to receive the care that they need to ensure both their health and the health of their babies. Also, the UVP and RVP supply-side design ensure that the programs are helping to stimulate local economies and bring communities together. All in all, while much progress must still be made towards increasing access to prenatal care for pregnant women around the world, Zimbabwe has taken an important first step with its Urban and Rural Voucher Systems.

– Kiran Matthias
Photo: Flickr

WinSenga, a technology developed by students from Uganda’s Kampala Makerere University, has revolutionized prenatal technology in the African nation. WinSenga was named after Microsoft Windows and Sengas; Sengas are aunts or midwives who help during pregnancy. The Sengas can be extremely helpful during a pregnancy and childbirth, but they can also rely on traditional practices that can harm both the mother and the child. The innovation has been supported by a $50,000 grant from Microsoft and is being built in a Microsoft-funded technology incubator at the University.

The appearance of the WinSenga is similar to that of a Pinard horn, which has been used by midwives throughout history.  The device is long and cone-shaped with a hole in the middle and a flat top in order for the midwife to place the device on the belly and listen to the fetus. The sounds of the fetus are then fed into a smartphone, which can analyze the heartbeat and recommend the best course of action.

The WinSenga is revolutionary in that it is available to anyone with a smartphone and the horn and can save thousands of fetus’ lives. The technology is also much cheaper so that clinics can accumulate its benefits. Juliet Birungi, an obstetrician in Uganda, also believes that WinSenga could be used to monitor the baby when the mother is in labor. Because Ugandan hospitals are often understaffed, the technology will allow staff to remain privy to the status of the infant. This is vital as abnormal heart rate in a fetus can be a sign of severe and life-threatening delivery complications.

Birungi stated that “just like all devices, they do not replace the need for a human being who is skilled…but this device would make their work easier, and the outcome would be much better.”

The application is set to expand into other developing nations with similar problems after its clinical trial in January of 2014.

Lienna Feleke- Eshete

Sources: WinSenga, All Africa
Photo: African App Project