How did Rwanda Operationalize Performance-based Financing ?. Results Based Financing Workshop October 20-24, 2008 Gisenyi, Rwanda. I. Context (before PBF). 1994-97: Reconstruction after the genocide (emergency situations, NGOs). Free of charge.
Results Based Financing Workshop
October 20-24, 2008
1994-97: Reconstruction after the genocide (emergency situations, NGOs). Free of charge.
1998-…Willingness to come back to development and government leadership. User fees.
1999: health facility indicators are degradating.
2001: Butare: willingness to move away from fixed bonus and observation of heterogenous performance across health centres.
PBF admin system allows for GOR and donor monies to flow through one channel: straight into the health facility bank accounts. E.g. MSH – USG contractor- pays HIV PBF in same account as GOR. Use of same management module, with database linked to payments. Other donors: ICAP-USG contractor, FHI and BTC do the same.
3. Careful assessment of incentives through HIV monies in PBF: solution found by protecting PHC services by linking payments of HIV and PHC monies to levels of quality of general services.
Unit Fee * Quantity * % Quality = Payment;
4. Global Fund is joining other partners in paying for HIV indicators into their supported sites (R7);
5. One national approach, same institutional set-up, same unit costs and same admin system facilitates alignment
Institutional set-up results? A challenge: the HIVAIDS money