Global Fund Voucher Scheme Project

Key Objectives: • Improve access to ITNs for the most at risk group of people (Pregnant women and children

under the age of 5). • Develop a sustainable scheme for delivering targeted subsidies for ITNs nationwide • Strengthen private sector provision of ITNs at reasonable cost through market priming • Enhance health staff capacity in promotion of ITNs and malaria prevention

In terms of rolling this scheme out to the seven southern regions of Ghana, it was initially proposed that Global Fund funds be used to continue the DFID pilot “voucher scheme project” that started in the Volta and Eastern Regions in 2004. Ashanti and Brong Ahafo regions were added to the scheme in 2005 and 2006 respectively. The Management Agent (Exp), as the central player in this scheme was contracted by the Ghana Health Service/Ministry of Health and was responsible for all administrative matters of the program, including the management of funds, auditing and the managing of vouchers in the system. Exp managed a team of 15 field agent’s who ensured that there was always an adequate number of vouchers in the field and offered support to ANC staff. Good relationships with the Commercial Partners were established at all levels of our business. Monthly & Quarterly Reports were sent to NMCP and Global Fund.

The Managing Agent ensured that proof of purchase stickers were actually attached to the nets. In the initial

stages of the project, many retailers that were supplied with proof of purchase stickers did not attach the

stickers to the nets when they were sold. This problem was reported and rectified immediately and

subsequently monitored on an ongoing basis.

The lists of health facilities supplied to the managing agent were not up to date which resulted in a number

of clinics being excluded from the initial distribution of vouchers. A monthly report detailing all health

facilities in a particular district was provided to each District Director.

The Voucher Scheme Management Agent served as the representative for the GHS (Principle Recipient of project funds) in the administration and management of the voucher scheme project. Over the four year period, a total of 648,126 vouchers were redeemed & all targets were met. The project value was $3,000,000.

Ongoing Supervision of Voucher distribution

Monitoring was implemented to provide an effective tool that ensured the efficient distribution of vouchers.

This ensured that additional voucher booklets were received before the health facilities run out of vouchers.

Ongoing research on stock levels and availability of ITN’s in the regions

It was very difficult for the management agent to assist the distributors in developing sales plans and

participate in training if nets were not available. This resulted in a plan to advance funding directly to the

supplier. The distributor repaid the debt by redeeming vouchers until the advanced funding payment was

repaid. It was imperative that the commercial partners ensured they always had sufficient stock to meet the

demands being created by the voucher scheme.

During the initial stages of the voucher scheme (2004), the commercial partners placed representatives into

health facilities in order to stimulate sales. This was stopped as soon as it was discovered and the

importance of the subject is re-addressed on a regular basis to maintain awareness. The reason this practice

was not encouraged is that it defeated the overall objectives of developing a sustainable commercial sector

in terms of ITN’s.