WASHINGTON, April 12, 2012 – With the Millennium Development Goals falling due in 2015, three Nigerian states—Adamawa, Nasarawa and Ondo—are rolling out major healthcare improvements with the support of the World Bank and other partners. As a result, over 9 million people, of whom 3.8 million are women aged 15-49 and children under age five, could gain access to better quality health services.
About 400,000 pregnant women need health services every year in these states, where the chances of giving birth with skilled help can be as low as 1 in 7. Changes are urgently needed to get more women from low-income households to use health facilities, and to make sure that these facilities offer lifesaving services such as skilled attendance during childbirth and immunization for children under age five.
The World Bank Board has approved financing of US$150 million today for the Nigeria State Health Investment Project, which will address this challenge by rewarding health workers and institutions that perform well, boosting performance management and accountability, and encouraging innovation. In addition, Nigeria will receive a US$21.5 million grant from the Health Results Innovation Trust Fund, supported by the UK’s Department for International Development and the Government of Norway.
“Three states in Nigeria are leading the way for others, using performance management techniques and increased incentives to health workers to boost the quality and uptake of health services” said Marie Francoise Marie-Nelly, World Bank Country Director for Nigeria, “I hope that these states will show how public money can be invested more smartly to get closer to the Millennium Development Goals, especially those related to the survival and health of mothers and children.”
Adamawa, Nasarawa and Ondo states have committed to major health systems reforms with the ultimate goal of providing a comprehensive and reliable package of health services at health facilities. Using their own resources, these states have already initiated pilot activities to jumpstart the reforms. Under the project, health facilities in these states will now be routinely paid for verifiable results such as the number of children immunized and the number of mothers delivering safely. In addition, the project will work to overcome institutional bottlenecks at state and local government levels, and provide technical assistance.
This “Results-Based Financing” approach will be evaluated to assess its impact and wider applicability in Nigeria, which accounts for 10 percent of global maternal deaths. Successfully employed at the national level in Rwanda and Burundi, this approach could spur significant progress in maternal and child survival in Nigeria. The three participating states in Nigeria vary widely in terms of health indicators, so will provide rich experience to guide future investments in health, both domestic and by development partners.
“We have a huge gap to cover in terms of achieving the health outcomes we desire for our people,” said Dr. Mohammed Ali Pate, Nigeria’s Minister of State for Health. “The Results-Based Financing approach will enable us to focus on those outcomes, because in the end it is not the process or the inputs that matter, it’s whether or not you are getting people to be healthier, or women surviving childbirth, or children surviving till the age of five.”