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Performance Based Financing: Building a Resilient Healthcare System

Learn about Cordaid's approach to Performance Based Financing (PBF) and how it is used to create a resilient, efficient, and effective healthcare delivery system. Explore the characteristics of PBF, its impact, expectations, and challenges.

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Performance Based Financing: Building a Resilient Healthcare System

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  1. Who am I? What is Cordaid? Performance Based Financing

  2. Why RBF? • What is RBF to Cordaid? • Characteristics/Principals • How does it work? • The Model • The System • Expectations • Challenges Performance Based Financing

  3. Why PBF? • Rwanda 2000: • Despite huge investments in the Health Sector; • Health Indicators did not improve. • “The system was able to absorb but not to improve” Performance Based Financing

  4. What is RBF to Cordaid? • What is Rerformance Based Financing to Cordaid? • RBF is a financing Strategy needed to build: • “A resilient, efficient and effective healthcare delivery system” Performance Based Financing

  5. Principals (Characteristics) • Pressure to Perform with the Sevice Provider (Finance on output) • No Monopolies (Separation of Purchaser, Provider and Regulator) • Public Private Partnership (Purchaser as a Multistakehoder organisation) • Decentralisation (Autonomous Management Health Facilities) • Rational management (Use of market mechanisms; demand/suppy) • Consumer participation (User fees, Health Commitees, Insurance) • Inclusion (Incorporation of private sector (non-profit or for-profit) • Equity (Solidarity and handycap systems) • Accountability (Purchaser, regulator and consumer verification) Performance Based Financing

  6. Forces Tools Negotiation Contracts Market Mechanisms Bussines Plans Surveys Participation Policies Enforcing Opinions Provider Purchaser Consumer Regulator The Model Performance Based Financing

  7. The System Performance Based Financing

  8. Impact Effect Outcome Output Activities Input The Chain of Results Attribution Context Performance Based Financing

  9. Expectations • Better financial access • (more efficiënt = lower user fees) • Better access to services • (more production and higher quality) • Beter physical access • (adequate referal, mainatained roads, transportation • Stronger Consumer Participation • More inclusion • Less Morbidity • Better Health Performance Based Financing

  10. Challenges • Access for the most vulnerable(inclusiveness) • Macro-financing(sustainability) • How to adapt to different contexts(flexibility) • How to deal with volitile situations (resilliance) • Integration Vertical Programs • Community Participation Performance Based Financing

  11. You get what you pay four piet.vroeg@cordaid.nl Performance Based Financing

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