Governor Dickson’s Safe Delivery Project

The Governor Dickson’s Safe Delivery Project is an SOML PforR Conditional Cash Transfer (CCT Plus) Initiative. Conditional cash transfers (CCT) are social intervention programmes that condition regular cash payments to poor households on use of certain health services and school attendance. CCT generally have a double objective: first, the programmes aim to provide a safety net to increase and improve the consumption of the extreme poor, and secondly to improve the Human Capital Investment of Poorhouseholds.

The SOML PforR CCT Plus Initiative is an expanded Model of Conditional Cash Transfer programme that conditions regular cash payments to poor households on use of certain maternal and child health (MCH) services as well as condition regular cash payments to health facilities/healthcare providers for provision of certain MCH services. The payment levels are intended to cover costs of accessing pregnancy care and delivery services in a health facility.

DEMAND CREATION IN SOML PforR

The CCT PLUS INITIATIVE serves to increase the utilization of health services in the health facilities through use of incentives provided after fulfillment of set conditions. These incentives are in form of monetary value and referred to as Conditional Cash Transfer (CCT). Pregnant women and the traditional birth attendants (TBAs) who identify pregnant women and refer them to the primary health centre (PHC) in the community for enrolment are the beneficiaries. People in developing countries are exposed to a range of risks that could reduce ability to lead productive lives, and pay for health care services. This makes them vulnerable. Therefore, social protection  mechanisms are developed to protect this vulnerable population. The mechanisms are geared towards equality, poverty reduction and human development. Thus this initiative will fulfill the threefold objective of creating equitable access to healthcare service, poverty reduction and human capital development.

SOML PforR CCT INITIATIVE aims to provide payment values created as incentives to promote health seeking behaviour among the target population of the very poor. The pregnant women will be paid N2,000.00 for booking for antenatal care (ANC) in a public health facility and then for meeting the other pre-conditions and delivery in a health facility she gets another N2,000.00 with a delivery kit while the TBAs will be paid N1,000.00 for every pregnant women they mobilize to register for ANC as they may be the first point of contact for the pregnant women. This is to encourage the TBAs to recommend ANC visits and registration with the CCT Plus programme.

DEMAND SIDE SOML PforR

The SOML PforR CCT PLUS INITIATIVE is developed to address both the demand creation and supply side of health services provision and utilization. The CCT Plus supply side creates funding support for health facilities by providing payment of N1,000.00 per delivery of a booked pregnant woman in the facility with other pre-conditions being met. Other programme activities enshrined in the SOML PforR are in consonance with the required components of the supply side of health care delivery by ensuring capacity building of programme officers & frontline health care workers, provision of essentials medicines according to national standards for PHCs and development and provision of minimum service package.

The Governor Dickson’s Safe Delivery Project chain of interventions consists of:

  1. Identification of Target beneficiaries: Target beneficiaries are pregnant women. NPower Volunteer Corps, ward development committees (WDCs) and resident health workers identify the beneficiaries and refer them to the PHC for enrolment.
  2. Select conditions and size of conditional cash transfer: Conditions were based on the use of 6 types of MCH services
    1. Booking
    2. Antenatal care (ANC)
    3. HIV counseling and testing (HCT/HTC)
    4. Use of long-lasting insecticidal net (LLIN)
    5. Skilled Birth Attendance
    6. Post-Natal Care/Immunization at birth
    7. Intermittent preventive treatment in pregnancy (IPTp)

The size of the transfer is N2,000 at each stage up to a maximum of N4,000. The rationale for setting these payment values is to incentivize positive behavioural change in women and prevent unintended, negative behaviour.