Maternal Care Patterns Clinical Trial
Official title:
Impact Evaluation of the Nigeria State Health Program Investment Credit (NSHPIC)
The World Bank and the government of Nigeria are implementing a results-based financing (RBF)
project for the states of Nasarawa, Adamawa, and Ondo. This project provides incentives for
improving performance at critical levels within the Nigerian health system and aims to
address some of these challenges. The primary goal of the impact evaluation of this project
is to determine if providing financial incentives linked directly to performance increases
the quantity and quality of maternal and child health (MCH) services.
In each of the three selected States,the project finances the following interventions:
1. Performance incentives to State Government and Local Government (LGA) agencies that are
triggered by Disbursement Linked Indicators (DLIs) that reflect strengthened supervision
and enhanced operational support for improving health systems performance. These
performance incentives would be paid out on an annual basis.
2. In half of the LGAs in each state, one facility per ward will receive Performance-Based
Financing (PBF) wherein payments are made directly to individual health facilities based
on the quantity and quality of a set of pre-defined services provided by each facility.
These performance incentives would be paid out on a quarterly basis.
3. In the other half of the LGAs in each state one facility per ward will receive
Decentralized Facility Financing (DFF) or equivalent financing that is not be linked to
any service delivery targets. These payments would be made on a quarterly basis.
The evaluation of the PBF arm, which consists of making payments to health facilities
conditional on performance, but within an environment of comparable levels of overall
financing, will rely on experimental assignment. The effect of the PBF intervention will be
identified by comparing outcomes in the LGAs receiving PBF versus those receiving DFF in the
three project states. In each of these three States, the LGAs will be randomly assigned to
either the PBF package or to the DFF package.
A detailed description can be found in the attached project concept note. ;
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