The MDGs for maternal and child health call on countries to reduce maternal mortality by three-quarters and child under-five mortality by two-thirds between 1990 and 2015. But most developing countries, especially those in Africa, will not achieve these MDGs unless progress is greatly accelerated.
To address this challenge, governments and development partners—including more than 40 low- and middle-income countries—are looking to results-based financing to increase the impact of investments in health. By explicitly linking incentives and results, this approach holds great promise for increasing health service use and improving service quality, efficiency, and equity. The aim is to focus on health results, such as the number of women receiving early antenatal care, and delivering their babies in health facilities.
In Afghanistan, the government reduced the death rate of children and infants from 257 and 165 to 97 and 77 per 1,000 live births, respectively, between 2002 and 2010. In Argentina, Plan Nacer, a social insurance program, aims to increase the health services use by pregnant women and children under age 5. Because of the program, nearly 1.5 million previously uninsured pregnant women and children now have basic health insurance and secure access to services. In Zimbabwe, the program’s goal is to increase coverage of maternal and neonatal health interventions in targeted districts by 2012. So far, 37,408 beneficiaries have benefitted from the pilot phase program conducted between July-August 2011.
The Health Results Innovation Trust Fund (HRITF) is funded by the governments of the United Kingdom and Norway, which have committed US$555 million to the trust fund through 2022. Other partners are recognizing the impact of HRITF-supported programs and are pooling additional resources for results-based financing.
Toward the Future
The Bank continues to focus on results-based health lending and is using the resources of the HRITF to leverage additional resources from the International Development Association. At the same time, the International Bank for Reconstruction and Development is continuing its backing for results-based financing in middle-income countries.