Development Impact Bond

A smiling women from India holds her baby - Text Overlay: The Maternal and Newborn Health Development Impact Bond. Photo Credit: Paul Joseph Brown / GAPPS


The Utkrisht Impact Bond – so named for the Hindi expression for ‘Excellence’ – is the world’s first health impact bond. It was developed by partners including USAID, Merck for Mothers, the UBS Optimus Foundation, PSI, Palladium, and HLFPPT.



Impact bonds are an innovative way to finance development. They are 100% focused on outcomes and have the potential to leverage private investor capital to address some of the world’s greatest challenges. The bond aims to reduce the number of mother and baby deaths by improving the quality of maternal care in Rajasthan, India's health facilities. It will enable implementing partners, Population Services International (PSI) and HLFPPT to support 440 Small Healthcare Organizations (SHCOs) to improve services, meet new government quality standards and adhere to them over the long term.

Through this public-private partnership, private capital from UBS Optimus Foundation will front the costs to improve the quality of health services in private health facilities in Rajasthan, and HLFPPT and PSI will use that capital to improve the quality of care in facilities and help them become accredited. As outcome payers, USAID and Merck for Mothers (known as MSD for Mothers outside of the US and Canada) will pay back the investment only if certain targets are met. Due to increased access to life saving supplies, appropriately trained staff, and the improved ability to address complications in labor, this effort has the potential to reach up to 600,000 pregnant women with improved care during delivery and save the lives of up to 10,000 women and newborns over five years. The pay for success approach ensures appropriate stewardship of US taxpayer dollars, while unlocking both private capital and government resources for health.


Icon: Mom and Baby


Save up to 10K WOMEN & NEWBORNS over 5 years

This partnership will reach up to 600,000 pregnant women with improved care during delivery and save as many as 10,000 lives over a five year period by improving the quality of private healthcare facilities that support a region of 75 million people. The State Ministry of Health in Rajasthan has signed a Memorandum of Understanding with the partners to invest in and scale up the partnership should the pilot program be successful.




To learn more about USAID's health work in Innovative Financing, please visit the Center for Accelerating Innovation and Impact.

Last updated: December 14, 2017

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