Project: RBF for Health System Strengthening in Lesotho
State of development: Current
Stage of development: Early stage
Stage notes: Feasibility/ scoping completed
Type of instrument — Impact Bond: No; Outcomes Fund: No; Social Impact Incentives (SIINC): No; Social Impact Guarantee: No; Payment-by-results (no pre-financing): Yes; Technical Assistance and Market-building program: No; Other: 
Part of a larger outcomes-based financing program: No 
Expected launch date: TBD
Total expected project development time: TBD
Expected length of project (years): 4.0
Project design process began: Q1-2023
Role of the domestic government — Outcomes funder: No; Service provider: Yes; Member of project committee: No; No formal role: No; Other: Implement/roll out complementary HSS strategies and oversee implementation
Service providers identified and selected — Request-for-proposals: No; Direct contracting by outcome funder/investor/intermediary: Yes; Provider-led deal development: No; Other: Through a rapid feasibility assessment that identified DHMTs as the service providers with the greatest potential to drive optimal delivery of PHC services.
Feasibility study: Yes
Proposed financing instruments — Debt: No; Equity: No; Guarantee: No; Grant: No; Other: 
Technical assistance grant: No — 
Estimated maximum potential outcome payment: TBD ~ USD 4.000.000 
Social/developmental challenge: The Lesotho health system faces significant challenges resulting in poor health outcomes that hinder productivity and impose a significant burden on the Government of Lesotho (“GoL”) and households in terms of health care expenditures, as well as hampers efforts to alleviate poverty in a country where 57% of the population lives in extreme poverty. 
Expected intervention model: (1) Create an enabling environment to improve primary health care (PHC) delivery by driving reforms in the planning, budgeting, and health financing policies and processes.
(2) Improve District Health Management Teams' (DHMTs) performance through incentives
Policy sectors — Employment and private sector development: No; Education: No; Social protection: No; Criminal justice: No; Health: Yes; Agriculture: No; Environment and climate change: No; Water, Sanitation and Hygiene: No; Energy: No; Humanitarian: No; Early Childhood Education: ; Other: 
Secondary SDG goals: 3
Target population: The Basotho people in all ten districtis of Lesotho.
Targeted number of unique service users or beneficiaries: ~TBD
Unit type of targeted beneficiaries: Individual
Country income classification of beneficiaries — Low-income: No; Lower-middle-income: Yes; Upper-middle-income: No; High-income: No
Notes: Data for this pipeline project was last updated in April 2022. 
Delivery location: Lesotho