With two years to go to meet the MDG targets – and with MDGs 4 & 5 lagging far behind, there is a clear need for new and innovative approaches to improving access to good quality maternal and newborn healthcare for poor women and their families.

Options' Results for Health consultants work in the area of output-based or results-based approaches to widening access to reproductive health services. We believe that, by linking payments to outputs or results, these approaches can result in more inclusive health systems in which priority services are provided to currently underserved population groups, or quickly scaled up, thereby improving the country’s overall health indicators, such as fertility rates, maternal mortality, or STI/HIV prevalence.

Paying for results – or for ‘work done’ – is particularly effective for:

• Empowering clients
• Reaching specific population groups such as the rural or urban poor, adolescents, sex workers or migrant workers
• Addressing specific health conditions, such as the need for long-term family planning, TB, vesico vaginal fistula, or safe delivery, especially for marginal and very poor people
• Enabling governments to harness the capacity of non-state providers
• Providing incentives and opportunities for providers to meet the needs of clients
• Driving technical quality improvements
• Promoting efficiency, accountability and transparency.
  

We believe in supporting governments to work effectively with the non state sector (both private for profit and not for profit). Given the prominent role of the private sector in health care provision in developing countries, and the often poor quality of services delivered through the private sector, there is a strong need to support governments to partner effectively with, and to leverage the potential of private sector providers in meeting their national and international targets. The challenge lies in ensuring that health products and services from both the public and private sectors are under the regulatory framework of the government, can be guaranteed to be of high enough quality, are accessible and affordable to those who need them most.

Results for Health consultants specialise in:

• Demand-side financing, including voucher programmes, cash transfer programmes, different forms of health insurance and pre-payment models
• Supporting the feasibility, design, monitoring and evaluation of results-based programmes
• Private (and increasingly public) Provider approval and accreditation systems development
• Contracting
• Public private partnerships.

 

Examples of our work include:

• Improving maternal and newborn health using results-based financing initiatives, Malawi
• Voucher management agency in Yemen
• In Mozambique, provided technical assistance for a review of demand-side financing approaches in response to a request by international development partners. The review assessed whether demand-side approaches could increase institutional delivery and, if so, whether vouchers or cash transfers would be the most effective way forward.
• In Malawi, led feasibility and design of a maternal and newborn health programme using results-based financing
• In India, advised state governments in West Bengal, Orissa, Madhya Pradesh and Bihar on Private Public Partnerships including policy and strategy development and the creation of PPP cells in government
• In Bihar, Odisha and Madhya Pradesh reviewed existing PPPs and supported the government to develop new PPPs including those for contracting out PHCs, Regional diagnostic Centres, Nursing Training, Surface Water Schemes.
• In Bihar, advised State Government on the design and implementation of a conditional cash transfer scheme to improve nutritional status of mothers and children under 3 using a RCT approach
• In Odisha, supported design of a Transport Management using to ensure private and publicly run ambulances serve remote and poor areas for institutional deliveries
• In Odisha, advising the State Government on a conditional cash transfer programme to improve maternal and newborn nutrition being implemented in 36 districts with a target population of 750,000 pregnant women per year.
• In Bihar and in Odisha, advised on the development of a state accreditation and regulation system for NGO and private health care providers
• In Nepal, supporting the development of a PPP policy and strategy. The wider Options-led consortium also supported the development of the Aama programme, the Government of Nepal’s maternity incentive scheme and free delivery policy
• In the Caribbean, Options is managing the KfW/PANCAP social marketing programme for HIV & AIDS prevention and reproductive health promotion on behalf of KfW
• In Honduras, Nicaragua, El Salvador and Guatemala, Options led a feasibility study and developed a ‘menu of options’ for innovative financing approaches for a re-oriented and enlarged sexual and reproductive health programme with focus on HIV and AIDS using the tool of RBF
• In Tanzania and Pakistan, Options was commissioned by Aga Khan Agency for Microfinance (AKAM) to investigate ways of widening the package of benefits for poor insured clients of its microfinance institutions as a pilot in Tanzania and investigated the potential to replicate this approach in Karachi, Pakistan.
• Developed a Guide to Private Sector Participation in Output-based Partnerships on behalf of MSI and currently developing this tool into a 'How To' guide for programme personnel on voucher programmes in sexual and reproductive health