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.
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.
On April 12, 2012 The World Bank Board has approved financing of US$150 million 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.
This RBF 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.