Nigeria - Program to Support Saving One Million Lives

closed

The objective of the Saving One Million Lives Initiative Program-for-Results (PforR) Project for Nigeria is to increase the utilization and quality of high impact reproductive, child health, and nutrition interventions. The first indicator will be tracked by income quintile to determine whether the poorest 40 percent of the population have experienced significant progress. The results to be achieved will be measured annually and targets will be based on the historical progress on these indicators in Nigeria and globally: (i) Increase in the combined coverage of six key SOML services; (a) vaccination coverage among young children; (b) contraceptive prevalence rate (modern methods); (c) Vitamin A supplementation among children 6 months to 5 years of age; (d) skilled birth attendance; (e) HIV counselling and testing among women attending antenatal care; and (f) use of insecticide treated nets (ITNs) by children under five; and (ii) improved quality of care index at health center level. Nigeria has made limited progress in the health sector over the last two decades which means that some 900,000 children and mothers are dying per year. The slow rate of progress has serious economic and development consequences. Simple solutions focused on improving inputs have not worked in the past but the availability of many of the needed inputs (such as health facilities and trained health workers) suggests that governance, broadly defined, is the binding constraint. This has been recognized by the Government which is why the SOML initiative provides an opportunity to change the game and boldly address governance and management issues. This PforR operation supports SOML and ensures: (a) a greater focus on results; (b) increased accountability; (c) improved measurement; (d) strengthened management; and (e) encouragement of innovation. Besides its direct effect on health outcomes, the operation provides an opportunity to test on a broad scale means for enhancing governance that could have consequences beyond the health sector.