Nigeria seeks World Bank’s approval to restructure $650m health loan

World Bank

Nigeria seeks World Bank’s approval to restructure $650m health loan

The Federal Republic of Nigeria is seeking the World Bank’s approval to restructure a $650 million loan allocated to the Nigeria Improved Child Survival Program for Human Capital (ICSPHC).

This is according to the “Restructuring Paper” on the program, which was seen by Nairametrics.

The program is a critical component of Nigeria’s broader health sector reform efforts, designed to reduce the under-five mortality rate from 132 per 1,000 births in 2018 to 79 per 1,000 by 2030.

According to the restructuring paper, this request follows the mid-term review of the project, which highlighted the need for strategic adjustments to better align with the government’s evolving approach to health sector reform, particularly in child and maternal health.

The document read: “This Restructuring Paper seeks the approval of the Country Director to carry out a Level-two restructuring of the Immunization Plus and Malaria Progress by Accelerating Coverage and Transforming Services Project (IMPACT P167156), the first phase of the Nigeria Improved Child Survival Program for Human Capital Multiphase Programmatic Approach (MPA).

“This Level 2 restructuring proposes to (a) revise the components and costs; (b) reallocate funds across disbursement categories; and (c) modify the Results Framework. This is the second restructuring of the IMPACT Project as it was restructured once in July 2021 and revised Component 2 to include financing the construction of the Lagos vaccine Hub.”

Proposed Changes

Although the project has been described as moderately satisfactory, the proposed restructuring involves several key changes to the project’s design and implementation strategy.

The Nigerian government intends to reallocate funds across disbursement categories, freeing up resources to expand the Basic Health Care Provision Fund (BHCPF) to additional states. This expansion will enhance access to essential health services, particularly in regions lagging in key health indicators. Also, the government plans to revise the project’s results framework, incorporating alternative data sources such as the Multiple Indicator Cluster Surveys (MICS) to address gaps in monitoring and evaluation.

The restructuring will also involve the deletion of specific activities, such as the centralized procurement of Long-Lasting Insecticidal Nets (LLINs) and other malaria commodities. Instead, participating states will manage their own procurement processes, ensuring timely delivery of malaria prevention tools. This shift is expected to improve the efficiency of malaria control efforts and support the broader goal of reducing under-five mortality.

Moreover, the restructuring includes the addition of a new sub-component focused on improving secondary health facilities and training institutions for healthcare workers.