WASHINGTON, May 6, 2010 – The World Bank’s Board of Executive Directors today approved an International Development Association (IDA) grant of US$22.8 million (about FCFA11.3 billion) to finance a Health System Performance Project (HSPP) in the Republic of Benin.
The main objectives of the new health project are to help increase the coverage of quality maternal and neonatal services in Benin, and to strengthen the institutional capacity of the Ministry of Health. More specifically, HSPP will contribute to improve: (i) the quality of maternal and neonatal health services, by enhancing the utilization of these services in 8 health districts of the country; and (ii) the allocation of government health funding across districts and facilities, by strengthening the Ministry of Health’s capacity and readiness for a sector-wide approach implementation. The new project will also receive a US$11 million grant from the Multi-Donor Trust Fund for Health Results Innovation (under co-financing arrangements). World Bank support is planned for four years.
The new project will be executed through three main components:
Component 1: Improvement of health facilities’ performance through Result-Based Financing (RBF)-- Under this component, health care facilities in the 8 selected districts would contract with the Ministry of Health and the financing for their services would be based on the results they achieve. These contracts would define the indicators and targets to be reached, and the results achieved against these targets would then be assessed by external reviewers every three months. Based on these verified results, each facility will receive an RBF credit.
Component 2: Improving financial accessibility (US$13.8 million)-- This component will help improve affordability of care in at least 4 RBF districts, by focusing on: (i) improving existing process for identifying the poorest populations; and on (ii) supporting the Ministry of Health team in charge of preparing a draft proposal for a future universal health insurance scheme. This component will strengthen processes for identifying the poorest and reinforce the impact of Component 1, as the RBF districts will be given incentives to provide better care to the poorest patients.
Component 3: Technical Assistance for Institutional Strengthening (US$2 million)— This third component focuses on the stewardship of the health sector, and would practically help improve several management functions at the Ministry of Health (planning, budgeting, and monitoring). It is expected that, by the end of the project, the Ministry will be able to produce plans and budgets that prioritize health facilities and evidence-based interventions, and that it will also be ready for implementing a sector wide approach: “one plan, one budget, and one monitoring and evaluation system”.
The HSPP is fully in line with Benin’s efforts to strengthen the performance of its health system. It would also foster synergy with other existing Bank projects in the country. Although the accountability component (RBF) is mostly focusing on maternal and neonatal health, indicators related to malaria prevention and treatment would also be included as a basis to determine the level of RBF credits received by health care facilities. This should improve the impact of the current Malaria Control Booster Program. It is also expected that the project would enhance the impact of the Poverty Reduction Strategy Credits series in the Health Sector, since these have consistently focused on improving accountability, decentralization and financial accessibility within the health system.
“We are happy that the Board has approved this new project to support the health sector in Benin, and we congratulate the Beninese authorities for this achievement,” said Madani M. Tall, World Bank Country Director for Benin. “The project will help improve basic services as well as governance and efficiency in the health sector. We expect that through its implementation, we can draw lessons that could be replicated in other sectors”.
 (i) The eight districts are : Adjohoun-Bonou-Dangbo; (ii) Covè-Ouinhi-Zangnanado; (iii) Kouandé-Ouassa-Pehunco-Kerou; (iv) Lokossa-Attiémé; (v) Bohicon-Zakpota-Zogbodomey; (vi) Banikoara; (vii) Ouidah-Kpomasse-Tori Bossito; and (viii) Porto Novo-Aguegue-Seme Podji.