Technical Support for Saving One Million Lives Program for Results

Program for Results (PforR) supported the Federal Government of Nigeria’s existing Saving One Million Lives (SOML) initiative, by providing incentives based on achievements of results (health outcomes) and helping to drive institutional processes needed to achieve these results. PforR uses country systems and processes, giving health managers substantial autonomy in managing and producing health results. States receive credit sums, as incentives for improved performance under the various Disbursement Linked Indicators (DLIs). States get rewarded for improvements in performance from their own baseline. The SOML PforR Program Development Objective is to increase utilization and quality of high impact reproductive health, child health and nutrition interventions. SOML PforR is not a parallel or separate program, but is instead a program leveraging existing efforts of States, potentiating existing commitments and strengthening existing systems.

Our Support focuses on enabling States to strengthen community structures, improve governance systems, and take up technology as a tool for continuous data collection, all targeted at improving the overall strategy of State interventions that drive results across the six pillars of the Program for Results. The available support also strengthens Program Conceptualization, Implementation, Monitoring and Evaluation of Public Health Programs that target improvements in outcomes across improving maternal, newborn & child health, improving routine immunization coverage & achieving polio eradication, elimination of mother to child transmission of HIV, scaling up access to essential medicines & commodities, Malaria control and improving Child nutrition.

The support looks to drive increment in percentage points for States across six quantitative indicators, thirty-four quality of care indicators and five performance management and governance indicators. Our support helps States make the most money that they can, from the world bank funding source, through increments across these indicators.

Our role in its entirety is to provide technology and technical support for the State to strengthen its health system and improve health outcomes, through improving monitoring and evaluation systems and data utilization, and through increasing the utilization of high impact Reproductive and Child health and Nutrition Interventions.

Our support to the Bayelsa State Saving One Million Lives Program for Results has been active since 2017, and has contributed to the State earning $1.5M and $960,000 in year 1 and in year 2 of our support. This support has focused on providing technical assistance to drive use of available resources through the internationally recommended Systems Thinking approach to developing and strengthening the State’s health system. This Systems Thinking has ensured that all human, material and financial resources committed to the sector have been channelled through the Health Systems building blocks, towards establishing a resilient and responsive health system in a bid to achieve universal health coverage for the people of Bayelsa State.

The Systems Thinking approach has also been built on a foundation of integration, including integration of systems level interventions as well as the integration of the delivery of services. Key evidence of these success has included improved governance frameworks in the health system in the State, including the eventual establishment of a State Primary Healthcare Board driven by the SOML PforR program, with full implementation of primary healthcare under one roof. There has also been a drastic improvement in the use of data for action within the health system catalysed by SOML PforR through the technical consultative group and steering committee meetings. There have been some service delivery gains, especially in the areas of Child Health and Child Survival, and key improvements in the participation of communities in the delivery of health services.

Bayelsa State, with our technical support boasts one of the most effective approaches to using SOML PforR resources in strengthening its health system, especially in the presence of very limited other funding for health systems strengthening during the period under review from 2017 to 2020. The focus is to dovetail these systems strengthening wins even further into the implementation of the State Strategic Health and Development plan. Intervention is also about to commence in Edo and Imo States.