This study examines the implementation fidelity of activities included in the Nigeria State Health Investment Project (NSHIP), including Performance-Based Financing (PBF) and Decentralized Facility Financing (DFF); exploring the behavioral changes brought about among health workers and within organizational structures and processes; and documenting the experiences of community members in accessing and using services from facilities receiving PBF and DFF. 

The determinants of primary health facility performance in developing countries have not been well studied. One of the most under-researched areas is health facility management. This study investigated health facilities under the pilot performance-based financing (PBF) scheme in Nigeria, and aimed to understand which factors differentiated primary health care centres (PHCCs) which had performed well, vs those which had not, with a focus on health facility management practices.

What does a midwife do all day? In Nigeria, approximately one million mothers and children die every year from preventable diseases. Many of these deaths can be avoided if pregnant women and young children received routine health care. To improve the quality of healthcare services and their use by women and children, the Government of Nigeria implemented the SURE-P Maternal and Child Health Project.

Evaluation Highlights In Nigeria, more than one in 10 children will not survive to see a fifth birthday, and nearly one in 20 women will die in childbirth. In collaboration with the Government of Nigeria, researchers are evaluating a program that aims to save the lives of mothers and their babies by improving access to reliable health services and increasing the demand for these services.

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.

Results-based financing programs collect and use operational data to provide information on the coverage, quality and equity of service delivery, with the added advantage that data are available real time.

With the Millennium Development Goals falling due in 2015, three Nigerian states—Adamawa, Nasarawa and Ondo—are rolling out major healthcare improvements via a Results-Based Financing (RBF) approach, 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.

African countries are embarking on an innovative strategy to improve health outcomes. In Nigeria, three states are implementing results based financing projects that put the health of families at the forefront of health service delivery.

Read more in this blog post.

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