Results-Based Financing to Improve Health Quality and Coverage in Hard-to-Reach Areas: The World Bank’s Experience in Africa

Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

Background: RBF programs are a core part of World Bank’s efforts to improve maternal and child health, particularly in Africa. There are currently 31 countries implementing RBF programs, including several countries with nationwide programs. A total of US$2.5 Billion in funding from The World Bank Fund for the Poorest Countries (IDA) and Health Results Innovation Fund (HRITF) is supporting the programs jointly with in-country support from bilateral and multilateral partners.

Methodology: The World Bank invests extensively in learning from this RBF portfolio with over 40 impact evaluations and mixed method studies. In addition by attaching a premium to results, RBF projects provide unique opportunities to track verified operational data to draw inferences.

Results: Using data from the ongoing programs, this presentation will highlight evidence that well-designed and supervised RBF programs can achieve results. In Rwanda, the RBF program improved coverage and quality of health services and improved population health outcomes (Christel MJ Vermeersch, 2011). In Burundi, over just one year, births at health facilities rose by 25% and prenatal consultations went up by 20%. The introduction of the RBF program contrib-uted to the dramatic reduction in child mortality from 176 per 1,000 to 96 per 1,000 from 2005 to 2010.   (Robert Soeters, 2013). Additionally, operational data from Nigeria, Zimbabwe and Zambia show that this approach can make health systems more efficient and accountable whilst improving both the quantity and quality of maternal and child health services delivered. (Health Results Innovation Trust Fund, 2013)

Conclusions: Results Based Financing can be one of the options for countries embarking on health systems strengthening activities to improve the utilization and quality of maternal and child health services.