Implementing private health facility-level savings plans to make antenatal care and childbirth affordable for the urban poor in Kampala, Uganda


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By Population Services International and Kampala Capital City Authority

In 2019, a formative research study was conducted by the Kampala Capital City Authority (KCCA) and Population Services International (PSI) with funding from USAID investigating knowledge, attitudes, and practices as well as barriers and facilitators to maternal and newborn health (MNH) services in urban slums in Kampala, Uganda. Findings revealed that even though women knew that pregnancy and childbirth services required a financial investment, few were able to save for antenatal care (ANC) visits and delivery. The average cost of this service package for ANC and delivery was approximately $64. The study findings showed that while families wanted to prepare for the future, they did not incorporate healthcare costs into their saving plans because they failed to make the connection between health and financial well-being. For the urban poor, healthcare is often not prioritized in face of other basic needs. There were a few facilities running some sporadic saving initiatives but with almost no clear formal procedures and systems.

The results from the formative study guided the development of a streamlined financial savings intervention as part of PSI’s USAID-funded Kampala Slums Maternal and Newborn Health project (MaNe) in Uganda. In February 2021, the MaNe project introduced a streamlined financing scheme in 20 private clinics to subsidize the cost of MNH services in the private clinics to the urban poor. One scheme focused on facility-based savings in which mothers and their spouses could make monetary deposits in installments to ensure that finances for antenatal care (ANC), delivery, and postnatal care (PNC) were available when needed.


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