This page is optimized for a taller screen. Please rotate your device or increase the size of your browser window.

The Partnership for Transforming Health Systems 2 (PATHS2)


  • Nigeria’s health system functioned at a low level.
  • An Abt-led project worked on governance to service delivery to private-sector partnerships to improve the health system.
  • The results have been dramatic. For example, access to better maternal, newborn and child health services in Northern Nigeria saved more than 140,000 lives.
The Challenge

Nigeria’s health system was a dysfunctional nightmare. Planning, financing, and delivery of basic health services for the poor all were unreliable. Maternal mortality and child morbidity were at unacceptable levels. 

The Approach

As the Partnership for Transforming Health Systems 2 (PATHS2) made progress, however, its work evolved from governance to service delivery to private-sector partnerships. The goal didn’t waver: improving child health and reducing maternal mortality. The project helped integrate informal health providers into the health system. It integrated the private sector by facilitating creation of lifesaving referrals via emergency transportation agreements. PATHS2 strengthened the drug supply system, leading to drug revolving funds in 535 health facilities, which guarantee a supply of high-quality, affordable drugs. PATHS2 established 1,098 community groups to influence the types and quality of services delivered in both public- and private-health facilities. In addition, the project trained traditional leaders and male gatekeepers to be advocates for maternal, newborn, and child health issues and conducted more than 3,500 health-care outreach events by trained health workers.

The Results

The results have been stunning. PATHS2 helped save more than 140,000 lives in Northern Nigeria by improving access to and availability of quality maternal, newborn, and child health services. It increased deliveries by skilled birth attendants from 13 percent in 2009 to 48 percent in 2015. Stockouts of essential drugs dropped from 96 percent in 2009 to 12.5 percent in 2016.  The project trained more than 18,000 community volunteers to recognize the danger signs of a difficult pregnancy, which produced faster referrals for emergency care and saved lives. The training increased the percentage of the public who can spot significant, pregnancy-related health problems from 4 percent in 2012 to 26 percent in 2016. The project helped pass the National Health Act, which ensures steady funding for health services by requiring dedication of 1 percent of the consolidated revenue fund to health care.

View a PATHS2 slideshow on Abt’s Facebook page.