Mama Rescue vs. Paper vouchers: Promotes Efficiency, Scalability, & Financial Control
Paper voucher systems to assist with transportation have shown to be effective at saving lives. Unfortunately, such systems are cumbersome and expensive to manage, are susceptible to fraud, and therefore limited in their ability to scale. Furthermore, paper systems do nothing to improve communication from providers at different health centers. Using an automated, cloud-based system resolves most of the challenges inherent in paper-based systems and also allows communication of critical information to the hospital, before an emergency referral arrives.
Paper is inefficient, with cumbersome overhead and office work
Paper voucher systems are inherently inefficient. Notification of drivers is done manually at the discretion of midwives. The most efficient driver is not necessarily selected and no clinical information is provided to the hospital. After the referral, vouchers must be submitted monthly to a log maintained by program staff. The claims must be verified by crosschecking and visiting each health center, the data is then summarized and funding requests are then submitted to a finance office. Drivers are not reimbursed for their services for 7 weeks. This process requires large amounts of administrative effort, verification and as a result it is expensive and cumbersome.
Despite this, successful paper voucher programs have been implemented in several countries, and substantially increased the demand for births in health centers. We believe that Mama Rescue can build on this success by reducing administrative effort to create an efficient, scalable system which can be expanded across Africa.
Mama Rescue is efficient, reduces administrative costs and sends critical information from health centers to hospitals
Mama Rescue is automated, efficient and 100% paperless. Numerous drivers are contacted simultaneously and the nearest driver is selected. While he is en route, clinical information is taken from a midwife and communicated to the hospital to prepare for the patient's arrival. Voucher reimbursement is immediate using mobile money sent to their phone, which can be collected at any mobile money agent. The result is more money going to helping women and newborns, with massively improved efficiency, transparency and security.
Paper systems are prone to abuse and fraud
Paper voucher systems work based on handwritten signatures written on the vouchers. Drivers can forge signatures to get reimbursed for services they did not provide, if they simply have the name of a registered midwife. Midwives can call drivers they know in exchange for a "kickback."
Mama Rescue is fraud-resistant
Emergency vouchers are created electronically and are only valid for a single phone number. They are easily tracked, and drivers are automatically selected. No signatures can be forged, and no numbers can be added without official registration to the system. Midwives are not able to choose the driver selected for the case, and drivers interested in participating in the program must agree to pre-negotiated rates, so there is no flexibility when it comes to payment amounts.
Fraud prevention in the case of ambulances:
Our payment system for ambulances was designed separately from the special hire taxi system. If ambulance drivers were paid in mobile money, there would be no guarantee that they would use it for fuel and not keep it for personal use. Therefore, ambulance fuel vouchers can only be redeemed at fuel stations registered in the Mama Rescue system, and they can only be redeemed in fuel for the ambulance. Fuel vouchers are kept secure by hospital adminsitrators and collected by drivers at participating fuel stations.
Paper voucher systems are not scalable
The amount of office work required to maintain a paper voucher program is immense. Though these projects have significantly increased demand for health center deliveries, the cost and administrative burdens have made them prohibitively difficult and expensive to expand.
Mama Rescue is scalable, adaptable, and expandable: locally supported and integrated with existing infrastructure:
Mama Rescue runs entirely on existing infrastructure (simple mobile phones, cars, drivers, and bodas), and on a software platform that was designed, programmed, and developed in Uganda, by Ugandans. Mobile phone networks are extensive and robust in Uganda, even in rural areas. Mama Rescue operates with MTN, the largest telecom provider in the country, and anyone with an MTN line is able to use the system at no cost. Mobile money use is growing everyday in Uganda and has become the most convenient method of payment (if you’re curious about mobile money, see our “What’s Mobile money?” section at the bottom of this page).
Given that all components of the Mama Rescue system are already integrated into most of East Africa and even beyond, we are confidant that Mama Rescue can be scaled and expanded nationally and regionally.
Mama Rescue is Data Friendly
As an electronic system, Mama Rescue records all data in real time, greatly facilitating record keeping and eliminating any loss of data. This allows our team to evaluate system usage and efficiency, and to identify challenges as soon as they occur. For example, if a new midwife wishes to create a case, she can call for support and her number can be registered immediately. The electronic database eliminates most of the administrative costs of maintaining the program, as data from any part of the system can be immediately viewed online. Data on outcomes and occurrences can be exported, analyzed and needed interventions can be targeted where they are needed most.
Below is a sample case summary and birth report. All data for individual cases is available in real time, and data for all cases can easily be exported in csv files for analysis.
FYI: What is mobile money:
Mobile banking is an extremely popular banking method used throughout Africa, and allows users to make payments using their cell phones. Cell phone use in Africa has risen at a staggering rate over the past decade, and the continent has almost entirely skipped the land-line stage of telecommunication. Mobile money has developed as a way to purchase locally, as well as to send money long distances using simple mobile phones. According to a recent Pew Research Center report, 42% of Ugandans use their mobile phones to make payments.
Payments made using mobile money are received instantly, and can be redeemed at any authorized mobile money dealer. These small stands and shops are extremely common, even in rural areas, making mobile money a very feasible banking system even for isolated communities.