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Demand Side Financing Project

Project
Demand Side Financing Project
Case Study: State Contributory Health Scheme Design
Client

Bill & Melinda Gates Foundation / Results for Development

Project Year

2017 - (Ongoing)

Geographic Scope

Nigeria (Kaduna and Niger states)

Area of Focus

Technical Assistance to the States in the Design and Implementation of State Contributory Health Scheme

Solutions

Health Financing

Background

Financial access is a key contributor to underutilisation of Primary Health Care (PHC) services in Nigeria. Healthcare is financed primarily through out-of-pocket expenditure which as of 2016, accounted for 70% of total health expenditure in Nigeria.

As part of on-going national health reforms aimed at reducing Out of Pocket Expenditure (OOPE) through pre-payment mechanisms, HSCL in collaboration with Results for Development (R4D) is providing technical assistance to the government of Kaduna, and Niger states for the design and implementation of a social health insurance scheme (pro-poor scheme) in both states.

Project Goal



To improve access to, and utilization of quality primary health care services and the reduction of out-of-pocket payments with an emphasis on pregnant women, children, and those living in poverty.

Objectives

  • Provide technical assistance for the design of state-level health financing mechanisms
  • Support the implementation, and evaluation of these mechanisms
  • Build the capacity of state actors to continue to provide sustainable implementation support after the duration of the investment.

Related Activities



  • Conducted a baseline assessment to generate evidence to guide scheme design
  • Review of the bill establishing the scheme to ensure alignment with best practices
  • Design of key components of the health insurance scheme including resource mobilization, pooling, purchasing, and performance management
  • Design of mechanisms for the definition, and identification of vulnerable and target populations
  • Support establishment of the Agency responsible for managing the scheme
  • Development of a Monitoring and Evaluation plan for the scheme