Transcript La bonne gouvernance - Performance Based Financing

Objectives
“To improve maternal and child health in
Zimbabwe”.
“by improving the availability, accessibility
and quality of key reproductive and child
health services and their optimal utilization”,
Project implementation
Through the establishment of a results based
financing fund, which is managed by a
National Purchasing Agency (NPA)
Project implementation
Results based financing introduces incentives which are aimed at
aligning individual and organizational goals general health system goals.
Inputs
Focus of
classic health
system
financing
Push
Health Facility
Activities
Results
Focus of
results based
financing
Pull
Components
Results based contracts with:
1. Provincial Management Teams
2. District Health Teams
3. Health centers, where the HCC, DHT and
the purchaser
4. Training, continuous supervision and
learning
Institutional setup
Indicators included
Primary Care - Health Centers Maternal Services, for
example:
 Curative care consultations OPD (new consultation)
 Antenatal care visits (4)
 Pregnant woman tested for HIV
 Delivery attended by skilled health worker in health
institution
 High Risk Maternal cases referral out
 Postnatal care visit
 First and repeat visits for FP modern methods
Indicators Included
Primary Care - Health Centers Child Services, for
example
 Child < 1 year fully immunized
 Vitamin A given to a child 6 to 59 months
Secondary level - Hospital Maternal Services
 Normal deliveries in district hospital
 Deliveries with complications (caesareans excluded)
 Caesareans performed
 Family planning: Tuba Ligations
Other Instruments
• Equity fund
• Verification by community organizations
• Benchmarking as learning tool
• NPA support to create plan to meet
minimal requirements
Timeline and Design Process
 March 2011 Preparation Grant signed and project
design process started
 Development of Project Implementation Manual
ongoing
 Learning by doing approach through selection of two
frontrunner districts
 Experience in frontrunner districts will be used to
finalize the project design
 Scale up to initially 2 districts per province
Thank for your
attention!