Can RBF Deliver for Women?

Jacqueline Sibanda's picture
June 5, 2013

They came from all corners, men and women, to re-focus the world’s attention on investing in women’s health and rights as a key to a more sustainable world for all. Over 4,000 academics, advocates, global health practitioners, policymakers, and storytellers, descended on Kuala Lumpur (KL), Malaysia, May 28-30, to shine a collective spotlight on the importance of building a better world for women and girls.

Hailed by the organizers as “the largest global meeting of the decade to focus on the health and well-being of girls and women,” Malaysia was a fitting choice to host the Women Deliver 2013 conference (WD2013). This Southeast Asian constitutional monarchy has made impressive progress on Millennium Development Goals (MDG) 4—reducing child mortality—and 5—improving maternal health, which, along with MDG 1—eradicating extreme poverty and hunger, are at the core of the Health Results Innovation Trust Fund’s (HRITF) work.

Participants at the Women Deliver event in Kuala Lumpur


Since 1990, Malaysia:

  • Has achieved its target to halve the number of people living on less than a dollar a day.
  • Has met its goal to reduce by two-thirds the number of children who do not live to see their fifth birthday.
  • Is on track to reduce by two-thirds the number of women dying during pregnancy or childbirth.

Read the Prime Minister of Malaysia’s welcome letter.

WD2013 participants came to share, learn, discuss, and debate the issues and solutions, bringing their passion, ideas, and questions about the health and well-being of women and girls to120 panels, workshops and side events. On May 28, HRITF hosted a side event to present initial results from its portfolio of results-based financing (RBF) programs, which comprises over five years of work through RBF approaches to accelerate progress on maternal and child health around the world. KL, complete with tropical weather, was a gracious host as more than 80 people from diverse organizations—including HRITF donor Norad, implementer Cordaid, governments, academia and private sector global health experts—came to hear how RBF is improving access to and the delivery of maternal and child health services for the most vulnerable in low and middle income countries.  

Results from the initial countries under implementation show a significant increase in the delivery as well as the quality of maternal and child health services:
  • More women are completing four pre-natal visits and delivering their babies with the support of skilled birth attendants, in Afghanistan.
  • The coverage of institutional deliveries in Burundi increased from 58% of estimated births to 68% with RBF.
  • In Nigeria, the quality score in facilities improved rapidly after introduction of the RBF program in December 2011.
  • Zimbabwe’s coverage of institutional deliveries increased from 46% in March to 74% in December 2012, and immunizations increased from 35% to 62% during the same period.
Monique Vledder, HRITF program manager, had this to say about the approach: Less than a thousand days away from the Millennium Development Goals (MDG) deadline, confidence is growing in the results-based approach amongst donors, governments and beneficiaries alike. RBF is producing results, with several countries reporting that more women and children are now able to get the care they need to improve their health outcomes.”
The conversation covered many topics that are often raised about the RBF approach, such as sustainability once donor-funded projects close; the removal of user fees—an issue also highlighted by World Bank President Jim Kim, in a recent speech at the World Health Assembly, as critical for achieving universal health coverage; and how RBF helps strengthen health systems by supporting autonomy at the facility level and incentivizes efficiency and greater accountability.
Learn more about HRITF in the progress report, which outlines the successes, challenges, and lessons learned so far.
Time and experience will tell if RBF can deliver for women. The promising data coming out of several countries in Africa and south Asia, along with growing interest from countries, as well as continued support from donors and the World Bank Group for RBF are all cause for optimism about the approach and its potential to make a real and sustainable impact on the health outcomes of women and girls.
In 2013, as in 2007 and 2010, the theme of the Women Deliver global conference was a simple and unapologetic call to action: “Invest in Women—It Pays!” Visit to learn more.



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