Transcript AC- niamey - UNFPA Niger

PERFORMANCE BASED
FINANCING
EMOC
MCH Department
MoH - Rwanda
Dr Aline Mukundwa, Niamey-Niger, June
2006
DEFINITION

PBF=strategy:
•
Finance Health Services
•
Increase Quality and Quantity
•
Respect of Norms
•
“Buy Results”
Dr Aline Mukundwa, Niamey-Niger, June
2006
PBF BASIC PRINCIPLES
Contract
to buy
care
Vendor
(Health Center
Hospital)
Contractor
(MOH,
Districts
Donors)
Performance
Motivation
Sale of quality
of care
Increase of
service to the
population
Dr Aline Mukundwa, Niamey-Niger, June
2006
OBJECTIVES

Access to Health Services (Geog; Finance)

Motivation/Responsibility of Staff

Quality of Service

Autonomy in Management of Health
Facilities
Dr Aline Mukundwa, Niamey-Niger, June
2006
INDICATORS FOR EMOC

Presentation of the Health Facility:
•
Names (hospital and health center)
•
Supervisor and supervised

Activity

Score
Dr Aline Mukundwa, Niamey-Niger, June
2006
INDICATORS FOR EMOC
CONT’D

ANC:
•
Organization/ Business Plan
•
Clinical Examination
•
Laboratory Tests
•
VAT
•
Care and Treatment
Dr Aline Mukundwa, Niamey-Niger, June
2006
INDICATORS FOR EMOC
CONT’D

Delivery:
•
•
Organization/ Business Plan
Direct Observations:
o
o
•

Equipment
Infrastructure
Direct Analysis/Competence
3rd stage:


Management of Complications
Hygiene
Dr Aline Mukundwa, Niamey-Niger, June
2006
INDICATORS FOR EMOC
CONT’D

Neonatal Care:
•
Apgar
•
Umbilical cord
•
Temperature
•
Congenital malformations
Dr Aline Mukundwa, Niamey-Niger, June
2006
INDICATORS FOR EMOC
CONT’D

Post-natal Care:
•
Clinical Examination
•
Laboratory Tests
•
Vit A, Mebendazole
•
Care and Treatment
Dr Aline Mukundwa, Niamey-Niger, June
2006
REPORTS & SUMMARY

Last recommendations taken into account

Problems identified

Actions to be taken
Dr Aline Mukundwa, Niamey-Niger, June
2006
REPORTS & SUMMARY
CONT’D

Summary:
•
Activity supervised
•
Points obtained
•
Difference(?)
•
%
•
Observations
Dr Aline Mukundwa, Niamey-Niger, June
2006
RESULTS
Evolution VAT 2-5
90
Couverture (%)
80
70
60
Kabutare
50
40
Gakoma
30
20
10
0
2001
2002
2003
2004
Année
Dr Aline Mukundwa, Niamey-Niger, June
2006
2005
RESULTS
Evolution of deliveries
45
Couverture (%)
40
35
30
Kabutare
Galoma
25
20
15
10
5
0
2001
2002
2003
2004
Year
Dr Aline Mukundwa, Niamey-Niger, June
2006
2005
CHALLENGES

Authenticity of Outputs
•
Control system

Remuneration Systems

Roles and Responsibilities
Dr Aline Mukundwa, Niamey-Niger, June
2006
LESSONS LEARNED

Further Exploration of the Strategy

Better Performance

Motivation of Personnel

Increase Sense of Responsibility

Importance of Control System

Good Preparation
•
Information
•
Competency
•
contracts
Dr Aline Mukundwa, Niamey-Niger, June
2006
CONCLUSIONS AND
RECOMMENDATIONS

Extension of the strategy

Different contracts at different levels

Community
•
Health center
•
Hospitals
•
Referrals hospitals
Dr Aline Mukundwa, Niamey-Niger, June
2006
Greetings from Rwanda
Dr Aline Mukundwa, Niamey-Niger, June
2006