Nigeria—Payment Models for Emergency Transport Schemes (METS)

One of the significant factors in reducing maternal mortality and morbidity in northern Nigeria is being able to access to emergency obstetric care services in a timely way. The team from the Payment Models for Emergency Transport Schemes for Obstetric Emergencies in northern Nigeria (METS) progamme tested how different incentives packages affected the performance and motivation of drivers involved in Emergency Transport Schemes 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 tested ranged from fuel vouchers, free vehicle servicing vouchers, and cash vouchers linked to distances traveled. 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 $9.33. If the women’s families had paid for these trips, the average cost would have been much higher at between $30 and $49, depending on the state.

METS covered four states in northern Nigeria (Jigawa, Zamfara, Yobe and Katsina) and was implemented alongside the 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.