Performance based financing and uptake of maternal and child health services in Yobe State, northern Nigeria

Authors: Garba M. Ashir, Henry V. Doctor & Godwin Y. Afenyadu
Journal Title: Global Journal of Health Science
Journal Reference: 5(3)
Document Type: Journal articles
Publication Date: 2013

Reported maternal and child health (MCH) outcomes in Nigeria are amongst the worst in the world, with Nigeria second only to India in the number of maternal deaths. At the national level, maternal mortality ratios (MMRs) are estimated at 630 deaths per 100,000 live births (LBs) but vary from as low as 370 deaths per 100,000 LBs in the southern states to over 1,000 deaths per 100,000 LBs in the northern states.

We report findings from a performance based financing (PBF) pilot study in Yobe State, northern Nigeria aimed at improving MCH outcomes as part of efforts to find strategies aimed at accelerating attainment of Millennium Development Goals for MCH. Results show that the demand-side PBF led to increased utilization of key MCH services (antenatal care and skilled delivery) but had no significant effect on completion of child immunization using measles as a proxy indicator. We discuss these results within the context of PBF schemes and the need for a careful consideration of all the critical processes and risks associated with demand-side performance based financing schemes in improving MCH outcomes in the study area and similar settings.

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Tags: Nigeria, Immunisation, Immunization, Maternal health, Maternal mortality ratio, Skilled delivery, Antenatal care, Child health, Millenium Development Goals, PRRINN-MNCH, Health systems research, Performance-based financing, Results-based financing, MNCH, RBF, Health systems strengthening, PBF, PRRINN, health systems impact, Increasing access to services, Yobe, increased utilization of services, demand-side PBF,