With World Bank support of $150 million, the Nigeria State Health Program aims to get more women to health facilities that offer lifesaving services including skilled attendance during childbirth and immunization for babies. To evaluate the impact of the new approach, Nigeria will also receive a $20 million grant from the Health Results Innovation Trust Fund, supported by the United Kingdom’s Department for International Development and the Government of Norway, and administered by the World Bank. Adamawa, Nasarawa and Ondo states are beneficiaries of the grant that will help roll out bold healthcare reforms which will focus on results at public health facilities. The reforms signal improved care for over 9 million people, of whom nearly 4 million are women aged 15-49 and children under age five. Every year, about 400,000 pregnant women need care in these states, where the chances of giving birth with skilled help can be as low as 1 in 7. Marie Francoise Marie-Nelly, World Bank Country Director for Nigeria said: “Three states in Nigeria are leading the way for others by rewarding health facilities for tangible results. I hope that they will show how public money can be invested smartly to get closer to the Millennium Development Goals, especially those related to the survival and health of mothers and children.” Under the program, health facilities will be paid for verifiable results such as the number of children immunized. Successfully employed in Rwanda and Burundi, this “Results-Based Financing” approach could help Nigeria rapidly reduce its current 10 percent share of global maternal deaths. “We have a huge gap to cover in terms of achieving the health outcomes we desire for our people,” said Dr. Mohammed Ali Pate, Nigeria’s Minister of State for Health. “The Results-Based Financing approach will enable us to focus on those outcomes, because in the end it is not the process or the inputs that matter, it’s whether or not you are getting people to be healthier, or women surviving childbirth, or children surviving till the age of five.” In addition to Results-Based Financing for health facilities, the program will also attempt to overcome institutional bottlenecks at the state and local government levels, and provide technical assistance. Rolled out more widely, such reforms could spur a significant decline in Nigeria’s high maternal mortality and under-five child mortality rates, which have declined slowly despite relatively high levels of spending on health. The three participating states vary considerably in terms of health indicators, so will provide rich experience to guide future investments in health, both domestic and by development partners.