One of the significant factors in reducing maternal mortality and morbidity in northern Nigeria is being able to access to emergency obstetric care (EmOC) services in a timely way. Piloting Payment Models for Emergency Transport Schemes for Obstetric Emergencies in northern Nigeria (METS) tested how different incentives packages affected the performance and motivation of drivers involved in Emergency Transport Schemes (ETS) in four states.
Funded by a MacArthur Foundation grant, this two year pilot was designed as an implementation research initiative, and aimed to generate evidence in support of an appropriately funded maternal health emergency transport policy.
The incentives that were tested ranged from fuel vouchers, free vehicle servicing vouchers, and cash vouchers linked to distances traveled. All the incentives, both cash and in-kind, were associated with higher performance among drivers. The average cost of the incentives per safe delivery or maternal death averted was US$ 9.33. If the women’s families had paid for these trips, the average cost would have been much higher at between US$ 30 – US$49, depending on the state. It is therefore not surprising that beneficiaries of the ETS and local communities in general were overwhelmingly positive about the service.
METS covered four states in northern Nigeria (Jigawa, Zamfara, Yobe and Katsina) and was implemented alongside HPI’s Partnership for Reviving Routine Immunisation in Northern Nigeria and Maternal Newborn and Child Health (PRRINN-MNCH) programmes which ran in the same four states, providing additional value for money.
A policy brief was produced to summarise the findings and policy implications.