The Gambia’s Community-Based RBF Scheme: Contracting Communities to Boost Demand

The Maternal and Child Nutrition and Health Results Project (MCNHRP) of The Gambia uses RBF to directly address challenges related to maternal and child nutrition and health, including sanitation and hygiene. The MCNHRP uniquely combines a supply-side performance-based financing (PBF) mechanism with a community-based RBF mechanism to foster stronger links between communities and health facilities. Its innovativeness further stems from the specific nature of its demand-side financing approach: the community-based RBF scheme in The Gambia contracts communities to create demand for services and promote the adoption of healthy behaviors – rather than contracting households as is typically done in demand side RBF interventions around the world.

To understand how the MCNHRP seeks to create an enabling environment for social and behavior change while laying the foundations for sustainable results, this paper examines its unique community-based RBF approach. It considers its rational, architecture as well as piloting and scaling-up processes, particularly focusing on lessons learned.