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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Performance-based financing for better quality of services in rwandan health centres: 3-year experience
Tropical Medicine and International Health, Volume 14, No. 7, Year 2009
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Description
In 2005, the Ministry of Health in Rwanda, with the support of the Belgian Technical Cooperation, launched a strategy of performance-based financing (PBF) in a group of 74 health centres (HCs), covering 2-m inhabitants. In 2006, PBF was extended to an additional group of 85 HCs, thus reaching 3.8-m inhabitants. This study evaluates the effect of PBF on HC performance from 2005 to 2007. Composite indicators for measuring quantity and quality of services were developed and evaluated through monthly formative supervisions by qualified and well-trained district supervisors. The strategy was based on a fixed fee per quality-approved service. The entire budget spent on the implementation of PBF amounted to $0.25/cap/year, of which $0.20/cap/year for subsidies and an estimated dollar;0.05/cap/year for administration, supervision and training. A positive effect on utilization rates was only seen for activities that were previously less well organized; in this case, growth monitoring services and institutional deliveries. The quality of services, defined as the compliance rate with national and international norms, rose considerably for all services in both groups. A sustained level of quality between 80% and 95% was reached within 18 months in the first group. A similar result was reached in the second group in 8 months. © 2009 Blackwell Publishing Ltd.
Authors & Co-Authors
Rusa, Louis
Rwanda, Kigali
Ministry of Health
Ngirabega, Jean De Dieu
Rwanda, Kigali
Ministry of Health
Janssen, Willy
Rwanda, Kigali
Belgian Technical Cooperation
Van Bastelaere, Stefaan
Rwanda, Kigali
Belgian Technical Cooperation
Porignon, Denis G.
Belgium, Brussels
Université Libre de Bruxelles
Vandenbulcke, Werner
Rwanda, Kigali
Belgian Technical Cooperation
Rwanda, Kigali
Ctb
Statistics
Citations: 119
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1111/j.1365-3156.2009.02292.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Study Design
Exploratory Study
Study Locations
Rwanda