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The World Bank approved $105 million equivalent in non-reimbursable grants for the Government of Mozambique’s Primary Health Care Strengthening ProgramforResults. Of this amount, $25 million equivalent is provided by the Global Finance Facility (GFF), and $80 million comes from the

International Development Association (IDA).   While Mozambique has registered improvements in social indicators since the end of the war in 1992, daunting challenges remain. The country is still ranked 181 out of 188 countries in the Human Development Index. Today’s economic and fiscal pressures, which are likely to continue in the short to medium term, are putting pressure on recent gains in social indicators.

A recent assessment of the primary health care system in Mozambique indicated that despite some improvements, the country is not yet on track to reach the health Sustainable Development Goals. It noted weaknesses in provider competencies; low adherence to clinical guidelines; high levels of dropout for child immunization; and little continuity in care delivery over time.

In response to these and other challenges, the Government developed a five-year program (2017-2021 - the Investment Case) focused on Reproductive, Maternal, Neonatal, Child and Adolescent Health and Nutrition that prioritizes the Health Sector Strategic Plan. The Investment Case program focuses on coverage, quality, and access to essential primary health care services, as well as data collection improvements and monitoring, among others.

The program will use a financing instrument called ProgramforResults (PforR), which allows for disbursements to happen only in a phased manner and based on achievement of preagreed targets. The program comprises a set of 11 indicators established jointly with the Ministry of Health and its Health Partners. The PforR tool is deemed appropriate given its combination of robust elements of technical assistance, capacity development, coordination, and monitoring to support enhanced service delivery. In addition, this operation draws on recent experience with resultsbased financing in Mozambique and is fully aligned with the World Bank Group’s Country Partnership Framework with Mozambique (2017-21).