The Gambia: World Bank Supports Efforts to Boost Nutrition and Health Services for Women and Young Children

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The FINANCIAL — The World Bank Group’s Board of Executive Directors approved a total of US$5 million in new financing for The Gambia to strengthen primary health care services and improve community nutrition for the country’s most vulnerable children and women. The project is expected to reach approximately 477,000 direct beneficiaries (children under five and women aged 15-49 years) by 2019. 

The additional financing in the form of an International Development Association (IDA) grant and a credit supports the original Maternal and Child Nutrition and Health Results Project, which brings community-based nutrition and primary health care services for women and children in three of the country’s poorest regions: the Upper River, the Central River, and the North Bank West Regions. The additional financing expands the coverage to the North Bank East and Lower River Regions, according to the World Bank.

The Gambia has been affected by the threat of two potential emergencies. The Ebola epidemic could surface in The Gambia at any time, which, given the weak capacity of the health system to respond effectively, is a major concern. Even with no Ebola cases reported till now, the tourism industry has taken a substantial hit. In addition, the 2014 rains arrived late and were erratic, affecting agriculture, which is heavily dependent on rain and the main source of livelihood for two thirds of the population. In The Gambia, maternal and child nutrition and health outcomes have to a large extent stagnated or even deteriorated. As a result, the maternal mortality ratio as well as the prevalence of stunting for children under-five in The Gambia are high and lag behind several nearby countries.

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The additional financing would consolidate early achievements and support the government’s response to the dual emergencies enhancing food and nutrition security activities, scaling up results-based financing for community nutrition and primary health care services, strengthening the Ebola response, and replenishing the initial reallocation of funds for Ebola. Enhancing household food security, community nutrition and primary health care will strengthen the resilience of communities and households to food and nutrition insecurity shocks.

 “This project is very innovative in that it combines the purchase of health and nutrition results from communities and health facilities through results-based financing,” said Rifat Hasan, World Bank Task Team Leader for this Project. “Through this reform, health facilities and communities are motivated to work harder and more closely together to improve the delivery and increase the use of better quality services for children and women’s nutrition and health.  By simultaneously addressing supply-side and demand-side barriers, the Maternal and Child Nutrition and Health Results Project will go a long way towards improving health and nutrition of vulnerable families.”

Under this project, health facilities will receive payments if they can show that their services have increased in number and improved in quality.  Similarly, communities will receive payments if they can show that indicators of hygiene, sanitation, and health and nutrition behaviors have improved.  Pregnant women will receive incentive payments for seeking antenatal care within the first trimester followed by three additional visits in the course of their pregnancy.  Today’s project combines supply-side and demand-side interventions to enhance community nutrition and primary health care for women and children, who often bear the most severe consequences, in the poorest regions with a longer term goal of contributing to poverty reduction and shared prosperity.

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