Performance Based Financing in Health Services Delivery in the Great Lakes Region - Africa

HealthNet TPO is an international NGO active in transition countries  and in so-called fragile States. HealthNet TPO encourages the development of autonomous and sustainable (public) health services delivery managed by skilled local people and supported by solid local structures and competent authorities. Performance contracts are awarded to health care providers with the capacity to develop and maintain a convincing provision of the basic health package to the target population.

The key concept of performance based financing (or in our francophone countries: l'approche contractuelle) is that health care providers increase their income or subsidy by attracting more patients and providing good quality care. Performance contracts ideally contain indicators with targets based on the population and morbidity patterns in their catchment area.  Innovation is encouraged; health facility managent may apply any strategy they feel is appropriate for their specific circumstances.

On 7 February 2005 HealthNet TPO received from the Dutch Ministry of Foreign Affairs a subsidy of € 5,533,573.00. The subsidy was granted under the Theme-based Co-funding scheme (TMF). The period for subsidy is 1 January 2005 till 31 December 2008. The grant is being used for a comprehensive rehabilitation of essential health care services  delivery in specific target areas in Burundi, DR Congo and Southern Sudan with a focus on sexual and reproductive health, HIV/AIDS and Malaria. Underlying this overall objective, we distinguish three key result areas: 1) Improved institutional capacity of health authorities, 2) Increased utilization of curative and preventive health care services and 3) Increased community involvement in, and satisfaction with, health service delivery.

MUAC, Mapel, May 2006

The HealthNet TPO Regional Office (RO) in Kampala, Uganda provides technical and managerial support. The staff at RO concentrates on capacity building, technical assistance & backstopping, organizing relevant consultant input, logistics support (especially to SSudan), instrument & policy development, cross-border exchange of knowledge & skills,  donor contacts & reporting, etc. Or in other words, RO sets the conditions for successful programme implementation at the following three sites:

Burundi: Kibuye secteur sanitaire, Gitega Province, consisting of 11 health structures serving a total of 228,120 people. Kibuye secteur sanitaire was selected by the MOH as a pilot for the introduction of a District health system in Burundi (hence Kibuye Health District). TMF station: Gitega.  

DR Congo: Butembo Zone de santé, North-Kivu Province, undertaken by the local NGO CIF- Santé on behalf of HealthNet TPO. The project covers 24 health centers serving a total number of 225,000 people. TMF station: Butembo.

Southern Sudan: The Jur County Health Systems Development project is located in Kwajena payam, Jur River County, Western Bahr el Ghazal Sate. Jur River County has an estimated population of 276,466 people. Kwajena payam where the project has initially started has an estimated population of 108,000 and 5 health structures under TMF support. TMF station: Mapel.