RBF in the Public Health Sector: Evidence of Impact and Essential Design Features
October 27, 2009
12:30 - 2:00PM
Agnes Soucat, HNP Advisor AFTHE
György Fritsche, Senior Health Specialist, HDNHE
Performance-based financing (PBF) in Rwanda evolved from relatively small projects covering defined geographical areas which were supported by NGOs, to an approach which was introduced nationwide, and delivered by the government. Whilst scaling-up through governmental systems, various changes were made to health system components. Some changes were concurrent/parallel to the PBF scale up, such as: (i) performance contracts between the Mayors and the President; (ii) national roll-out of community based health insurance and (iii) decentralized salary budgets.
Understanding essential design elements of the Rwandan PBF model is important when thinking about how to scale up such programs through the public system in low-income countries. PBF is not a panacea and certainly not a ‘simple incentive system’; it is rather more like a health system reform. The fact that we now have hard evidence from a rigorous impact evaluation means that Rwanda-style PBF has moved firmly from an ‘emerging good practice’ to an ‘evidence based intervention’.
This seminar will: (i) show some of the results of the impact evaluation; (ii) point out the importance of including well-designed impact evaluations when PBF models are first introduced; (iii) show crucial design features of the Rwandan health center PBF model.
Chair: Benjamin Loevinsohn, HNP Cluster Leader, AFTHE
Agenda & Course Materials