Gambia, The

Authors: Jean-Benoit Falisse; Petra Vergeer; Joy Gebre Medhin; Maud Juquois; Alphonse Akpamoli; Jake Robyn; Walters Shu; Michel Zabiti; Rifat Hasan; Bakary Jallow; Musa Loum; Cedric Ndizeye; Michel Muvudi; Baudouin Booto; Jean Claude Taptue Fotso; Severin Sokegbe; Ibrahim Magazi; Gil Shapiro

The Maternal and Child Nutrition and Health Results Project (MCNHRP) of The Gambia uses RBF to directly address challenges related to maternal and child nutrition and health, including sanitation and hygiene. The MCNHRP uniquely combines a supply-side performance-based financing (PBF) mechanism with a community-based RBF mechanism to foster stronger links between communities and health facilities.

Qualitative studies endeavor to answer the “how” and the “why” of Results-Based Financing (RBF) mechanisms in the health sector. For instance, how does implementation work toward a specific health outcome? Why does a program lead to positive health results in a specific setting and not in another? How do communities engage with the health system? Why are improvements in the quality of care not generating intended increases in service utilization?

There is a great deal of evidence of “what works” in global health. Translating this evidence into results, however, is a challenge and requires acute attention to its delivery or implementation.

Effectively implementing evidence is an active process and requires a continuous cycle of learning. It is a science that involves the systematic identification and analysis of the factors that affect implementation, and the series of actions that are taken to address them. Knowledge dissemination and sharing is also a part of this science— the science of delivery.

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