Start: 2011 in three States  – scaling up during 2017 towards 5 new States
Phase: Scaling up
Coverage Estimate: 6%
Feasibility: Reasonable
Supported by: WB; States

Description: The World Bank is currently funding until 2018 a large health program with PBF pilots in three States (Adamawa, Nasarawa and Ondo). Additional funding is reserved for the extension of PBF to five North-Eastern States (Borno, Yobe, Gombe, Bauchi, Taraba State). It is important to feed the experiences of the three pilot states into the discussions about how to best scale up PBF to the new States. It is important to move beyond the ‘pilot’ and ‘project’ approach of the current programs towards a reform approach. The Ministry of Health should also become more at the centre of the PBF reforms instead of that the leading role is mainly done by the National Primary Health Care Development Agency. Efficiency gains may be obtained by combining standard supervisions with the PBF quality reviews, addressing autonomy issues, and introducing PBF contracting also at the regulatory level and for the CDV Agency actors of the system.