Financing Health in Africa - Le blog
  • Home
  • Bloggers
  • Collaborative projects
  • Join our COPs
  • Resources
  • About Us
  • Contact Us

The challenge of scaling up & integrating RBF

1/9/2017

1 Commentaire

 
Bruno Meessen
In late 2014, the Alliance for Health Policy and Systems Research along with the Department of Health Governance and Financing,  WHO launched an implementation research program “Taking Results Based Financing from scheme to system”. The main purpose of this program was to generate research knowledge useful for all the countries engaged in scaling up their Results-Based Financing (RBF) programs. The research is now over and the program has entered its dissemination phase. The Performance Based Financing Community of Practice supports the communication effort of this multi-country program of research.

Picture

As far as low-income countries are concerned, the first applications of the Performance Based Financing (PBF) approach can be tracked back to the late nineties in pioneer countries such as Haiti and Cambodia. Over the next 20 years, the strategy has grown in popularity and has been adopted by an increasing number of countries. Some early adopters, like Rwanda or Burundi, rapidly transitioned from a pilot experience to a national policy. In some other countries, the adoption is much more recent, things are simply taking more time and in others RBF has failed to come on to the policy agenda.

The policy process through which a country moves from the idea to test RBF to a fully-fledged national policy is far from straight-forward. It is about developing a proof of concept, addressing national public health problems, gathering support among a large set of stakeholders, raising funds… So far, knowledge on how to overcome all these obstacles has not been systematized and synthesized.

When reflecting on the expansionary policy development of a RBF or PBF scheme, it is also important to put it into perspective. PBF is not an end in itself – it is a strategy to improve performance of the national health system, in terms of outcomes for the population, general efficiency and equity. Therefore, the issue of scale up must be understood in a broad sense: policy makers and analysts have to take into account the necessity to integrate the strategy in the broader effort to establish a coherent national health financing system as opposed to expanding a scheme as a narrowly focused intervention framed as an end in itself.

It is with this two main considerations in mind that  the Alliance for Health Policy & Systems research spearheaded the research program “Taking Results Based Financing from scheme to system”. The research was carried out in 2015 by national teams from 11 countries: Armenia, Burundi, Cambodia, Cameroon, Chad, Kenya, Macedonia, Mozambique, Rwanda, Tanzania, Uganda. The program was funded by the Alliance for Health Policy and Systems Research supported by NORAD with technical support from a team based at the Institute of Tropical Medicine, Antwerp.

Many of you contributed to this process, as researchers or as key informants. Some of you have already heard about our findings at  international conferences, in Dar-Es-Salaam, Harare, Rabat and Vancouver. But many of you are also active in countries not covered by the program or have missed our face-to-face events. There will be three channels to catch up. We of course recommend that you  use these opportunities together:  indeed they complement each other well.

Webinars


We have agreed with Joël-Arthur Kiendébréogo and Nadège Ade, the editorial team of the CoP webinar series, to organize a series of webinars to present some key findings.

The first webinar will introduce the research program. It will be presented by the two scientific coordinators of the program (Zubin Shroff and myself). In this webinar,  we will present the research program as a whole as well as the main lessons learnt.. Among other things, we will present the multi-dimensionality of  scale-up (it is much more than covering the whole country!), we will propose to analyze any PBF scale-up as a process going through four main stages and provide an overview of barriers and facilitators for scaling up a RBF scheme. We believe that this is strategically useful information to all those of you directly or indirectly involved in the design, implementation and study of PBF schemes.

With 11 countries, we have potentially a large number of country cases to present. Our intention therefore is to organize a few webinars focusing on some country cases. The actual number of cases will partly depend on the interest observed at the first webinar.

We will schedule these different webinars in the weeks to come. Note that the first webinar (general presentation of the research program) is scheduled for January 18th 1-3 pm, GMT. It will be in French and you will have to connect here. The same content will be presented in English on January 20th (1-3 pm GMT  as well).It will be here.  We recommend you to save the dates in your agenda. For more detailed and up-to-date information, it is recommended to register to our PBF online forum.

As a reminder, a webinar consists of a 60-90 minute online session with a power point presentation and a discussion at the end. To participate, you will have to install the WebEx program on your computer and have a sufficiently good internet connection at the time of the session. More guidance is provided here. The webinar team is also ready to help those for whom it is the first WebEx webinar ever, but you must alert them in time. You contact them here.


Policy briefs


The case studies carried out in the 11 countries provide a wide range of experiences. We have selected three interesting cases, at different points of the scale up process for illustration through  policy briefs. They are about the story of Chad (where the PBF pilot project never transitioned to a national program), the experience of Cameroon (which had to transfer the purchasing capacity from external actors to regional semi-autonomous entities) and the full scale-up of Armenia (whose PBF program was integrated within a plan of Primary Health Care revitalization, including in it a non-communicable disease component). A fourth policy brief synthesizes the enablers and barriers to scale up identified from the review of ten country experiences.  

These policy briefs will be officially published in the weeks to come. They will be introduced here on Health Financing in Africa. We hope that they will be useful materials for your own policy development or teaching.


Papers


Finally, we have agreed with the journal Health Systems and Reform  to develop a supplement consisting of  a series of papers presenting findings from our multi-country program. This is of course a venture demanding a bit more time, as papers have to go through a rigorous peer review process. We expect the first papers to be published in Spring 2017. We will of course keep you informed of their publication.

1 Commentaire
BALY
1/12/2017 01:47:39 pm

Heartfelt thanks for this great job that you have achieved.
As I haven't got your paper my query is to know how the private sector can play a role in the implementation of this scheme.

Répondre



Laisser un réponse.


    Our websites

    Photo
    Photo
    Photo

    We like them...

    SINA-Health
    International Health Policies
    CGD

    Archives

    Septembre 2019
    Juin 2019
    Avril 2019
    Mars 2019
    Mai 2018
    Avril 2018
    Mars 2018
    Février 2018
    Janvier 2018
    Décembre 2017
    Octobre 2017
    Septembre 2017
    Août 2017
    Juillet 2017
    Juin 2017
    Mai 2017
    Avril 2017
    Mars 2017
    Février 2017
    Janvier 2017
    Décembre 2016
    Novembre 2016
    Octobre 2016
    Septembre 2016
    Août 2016
    Juillet 2016
    Avril 2016
    Mars 2016
    Février 2016
    Janvier 2016
    Décembre 2015
    Novembre 2015
    Octobre 2015
    Septembre 2015
    Août 2015
    Juillet 2015
    Juin 2015
    Mai 2015
    Avril 2015
    Mars 2015
    Février 2015
    Janvier 2015
    Décembre 2014
    Octobre 2014
    Septembre 2014
    Juillet 2014
    Juin 2014
    Mai 2014
    Avril 2014
    Mars 2014
    Février 2014
    Janvier 2014
    Décembre 2013
    Novembre 2013
    Octobre 2013
    Septembre 2013
    Août 2013
    Juillet 2013
    Juin 2013
    Mai 2013
    Avril 2013
    Mars 2013
    Février 2013
    Janvier 2013
    Décembre 2012
    Novembre 2012
    Octobre 2012
    Septembre 2012
    Août 2012
    Juillet 2012
    Juin 2012
    Mai 2012
    Avril 2012
    Mars 2012
    Février 2012
    Janvier 2012
    Décembre 2011
    Novembre 2011
    Octobre 2011

    Tags

    Tout
    2012
    Accountability
    Aid
    Alex Ergo
    Assurance Maladie
    Bad
    Bamako Initiative
    Bénin
    Bruno Meessen
    Burkina Faso
    Burundi
    Civil Society
    Communauteacute-de-pratique
    Communauté De Pratique
    Community Of Practice
    Community Participation
    Conference
    Cop
    Course
    Couverture Universelle
    CSU
    Déclaration De Harare
    Divine Ikenwilo
    Dr Congo
    économie Politique
    élections
    équité
    Equity
    Fbp
    Financement Basé Sur Les Résultats
    Financement Public
    Fragilité
    Fragility
    Free Health Care
    Global Fund
    Global Health Governance
    Gratuité
    Gratuité
    Health Equity Fund
    Health Insurance
    ICT
    Identification Des Pauvres
    Isidore Sieleunou
    Jb Falisse
    Jurrien Toonen
    Kenya
    Knowledge-management
    Kouamé
    Leadership
    Mali
    Management
    Maroc
    Maternal And Child Health
    Médicaments
    Mise En Oeuvre
    Mutuelle
    National Health Accounts
    Ngo
    Niger
    Omd
    OMS
    Parlement
    Participation Communautaire
    Pba
    Pbf
    Plaidoyer
    Policy Process
    Politique
    Politique De Gratuité
    Politique De Gratuité
    Post Conflit
    Post-conflit
    Private Sector
    Processus Politique
    Qualité Des Soins
    Qualité Des Soins
    Quality Of Care
    Recherche
    Redevabilité
    Reform
    Réforme
    Research
    Results Based Financing
    Rwanda
    Santé Maternelle
    Secteur Privé
    Sénégal
    Société Civile
    Uganda
    Universal Health Coverage
    User Fee Removal
    Voeux 2012
    Voucher
    WHO

Powered by Create your own unique website with customizable templates.