Bruno Meessen
Five years ago, the Performance Based Financing Community of Practice was launched in Bujumbura. We can be proud of what we achieved. The future looks even more promising.
Flashback
In 2010 (February 2-6), more than 100 experts gathered in Bujumbura for a Performance Based Financing (PBF) workshop. Participants capitalized on the event to launch a community of practice (CoP). The ones among us who were in Bujumbura in 2010 certainly remember a week of passionate discussions between peers, without any interference of projects or agency agendas. In these early days, we already covered topics which continue to inspire and mobilize us: the link between PBF and quality of care, for example, the challenges posed by specific health problems such as nutrition, scaling up PBF or community PBF (just to list a few of the sessions). More fundamentally, we developed very strong bonds among experts. Five years later, these bonds have only become stronger, in line with the PBF momentum itself.
The workshop also marked our way of doing things, and more in particular how we conceive and set up face-to-face events: there was a keen interest for new questions, the stage was given to the practitioners and there was an overall concern to build bridges between actors. With the CoP, we have also rapidly started some online activities. Our online forums – the google group was launched just a couple of weeks after the workshop and our blogs Health Financing in Africa and performancebasedfinancing.org were launched a bit later – rapidly became key platforms for the CoP. They host passionate debates, sharing of experiences and exchange of ideas. The google group has also become a space where professional opportunities are shared: new vacancies, upcoming training sessions or conferences,...
Over these five years, our community of experts has defended – sometimes vigorously - some principles which are dear to us, but we have also proven our capacity to criticize ourselves, when needed, and update our vision (even if on this respect, I believe we could do even more). Together with other actors such as national governments and the World Bank, we have put PBF at the heart of health systems and… triggered a revolution.
PBF is not a goal in itself : it is there for populations, for the efficacy and effectiveness of our health systems. It can still be improved. We know that it is with this view in mind, that many of you joined our online discussion group. Today, the PBF CoP consists of more than 1500 experts : practitioners, senior cadres, researchers, technical assistants…
What’s next ? Maybe another revolution !
Just like you, I believe that the current PBF momentum will continue in many countries in the coming years; perhaps, it will require another name (during these years, we also experienced that the acronym PBF unnecessarily antagonized some actors that should have been natural allies) and the approach will no doubt still evolve. What really matters, though, is what has already been achieved: PBF has opened stakeholders’ eyes to the importance of incentives in the health system (we hope none of you still make the mistake of equating incentives with bonuses!). It has also provided health systems with new mechanisms, such as strategic purchasing.
It is obvious that many of the principles we are advocating for have all it takes to become “mainstream”. To achieve this status, though, PBF experts should avoid becoming dogmatic and accept the need to align/seek synergies with other strategies – like the health district – or consolidate global objectives – such as universal health coverage. But we should never compromise on the bottom-line: impact for the populations!
The PBF CoP should continue to play its role in this soft revolution. This will require a transformation of the CoP itself. Over the last years, I regret to say, I was too often a bottleneck myself. My new responsibilities at ITM, but also my willingness to accompany other CoPs – to ensure the future of our CoP, it was crucial to demonstrate the validity of the CoP strategy beyond PBF – have sometimes limited my availability for the PBF CoP. Several activities were put in the fridge.
But now it’s time to move forward, as we celebrate this fifth anniversary.
Last December, we had a meeting in Rabat, Morocco, with facilitators of other CoPs. A new vision emerged. My own ‘déclic’ came from the observation that several experts present in Rabat were themselves members of several CoPs. My analysis is that in the future, we will have more and more activities co-organized by several CoPs (like our Muskoka study for instance). More fundamentally, we must better integrate the fact that our experts have different fields of interest (which may change as their career progresses) in our activities; experts typically also have various skills which could be tapped in a more flexible way. For our CoPs to grow, we need technical experts, obviously, but also translators, event organizers, reviewers… and even cartoonists!
In the following months, you will learn more and more about this new vision which will offer rich opportunities for many among you. This new vision is not pie in the sky: to make it come true, we have received funding of nearly 900.000 € from NORAD, the Norwegian Aid Agency. Our level of ambition is high: we want to launch a platform which may, one day, revolutionize the way collaborative work in global health is organized.
As you are about to discover, we will move increasingly to a model whereby experts will be able to showcase their contributions better (thanks to the fact that we will better measure respective contributions of each expert). Setting up this new model will take us at least two years. It is innovative and potentially disruptive, so risk and uncertainty are unavoidable. The pilot stage will be crucial. The NORAD project is designed in such a way that the PBF CoP will spearhead the innovation. So, stay tuned to this blog for the months to come. You will soon find out that you will have a key role in the success of this exciting new endeavor.
But now, let’s take a moment to celebrate and congratulate ourselves for what we have achieved together in five years. Feel free to leave a comment at the bottom of this blog. More in particular, we would like to know from you how you have experienced these five years. What changes have you witnessed in your country, as far as PBF is concerned? How has the CoP assisted you during this period? These testimonies will continue to inspire us…
Five years ago, the Performance Based Financing Community of Practice was launched in Bujumbura. We can be proud of what we achieved. The future looks even more promising.
Flashback
In 2010 (February 2-6), more than 100 experts gathered in Bujumbura for a Performance Based Financing (PBF) workshop. Participants capitalized on the event to launch a community of practice (CoP). The ones among us who were in Bujumbura in 2010 certainly remember a week of passionate discussions between peers, without any interference of projects or agency agendas. In these early days, we already covered topics which continue to inspire and mobilize us: the link between PBF and quality of care, for example, the challenges posed by specific health problems such as nutrition, scaling up PBF or community PBF (just to list a few of the sessions). More fundamentally, we developed very strong bonds among experts. Five years later, these bonds have only become stronger, in line with the PBF momentum itself.
The workshop also marked our way of doing things, and more in particular how we conceive and set up face-to-face events: there was a keen interest for new questions, the stage was given to the practitioners and there was an overall concern to build bridges between actors. With the CoP, we have also rapidly started some online activities. Our online forums – the google group was launched just a couple of weeks after the workshop and our blogs Health Financing in Africa and performancebasedfinancing.org were launched a bit later – rapidly became key platforms for the CoP. They host passionate debates, sharing of experiences and exchange of ideas. The google group has also become a space where professional opportunities are shared: new vacancies, upcoming training sessions or conferences,...
Over these five years, our community of experts has defended – sometimes vigorously - some principles which are dear to us, but we have also proven our capacity to criticize ourselves, when needed, and update our vision (even if on this respect, I believe we could do even more). Together with other actors such as national governments and the World Bank, we have put PBF at the heart of health systems and… triggered a revolution.
PBF is not a goal in itself : it is there for populations, for the efficacy and effectiveness of our health systems. It can still be improved. We know that it is with this view in mind, that many of you joined our online discussion group. Today, the PBF CoP consists of more than 1500 experts : practitioners, senior cadres, researchers, technical assistants…
What’s next ? Maybe another revolution !
Just like you, I believe that the current PBF momentum will continue in many countries in the coming years; perhaps, it will require another name (during these years, we also experienced that the acronym PBF unnecessarily antagonized some actors that should have been natural allies) and the approach will no doubt still evolve. What really matters, though, is what has already been achieved: PBF has opened stakeholders’ eyes to the importance of incentives in the health system (we hope none of you still make the mistake of equating incentives with bonuses!). It has also provided health systems with new mechanisms, such as strategic purchasing.
It is obvious that many of the principles we are advocating for have all it takes to become “mainstream”. To achieve this status, though, PBF experts should avoid becoming dogmatic and accept the need to align/seek synergies with other strategies – like the health district – or consolidate global objectives – such as universal health coverage. But we should never compromise on the bottom-line: impact for the populations!
The PBF CoP should continue to play its role in this soft revolution. This will require a transformation of the CoP itself. Over the last years, I regret to say, I was too often a bottleneck myself. My new responsibilities at ITM, but also my willingness to accompany other CoPs – to ensure the future of our CoP, it was crucial to demonstrate the validity of the CoP strategy beyond PBF – have sometimes limited my availability for the PBF CoP. Several activities were put in the fridge.
But now it’s time to move forward, as we celebrate this fifth anniversary.
Last December, we had a meeting in Rabat, Morocco, with facilitators of other CoPs. A new vision emerged. My own ‘déclic’ came from the observation that several experts present in Rabat were themselves members of several CoPs. My analysis is that in the future, we will have more and more activities co-organized by several CoPs (like our Muskoka study for instance). More fundamentally, we must better integrate the fact that our experts have different fields of interest (which may change as their career progresses) in our activities; experts typically also have various skills which could be tapped in a more flexible way. For our CoPs to grow, we need technical experts, obviously, but also translators, event organizers, reviewers… and even cartoonists!
In the following months, you will learn more and more about this new vision which will offer rich opportunities for many among you. This new vision is not pie in the sky: to make it come true, we have received funding of nearly 900.000 € from NORAD, the Norwegian Aid Agency. Our level of ambition is high: we want to launch a platform which may, one day, revolutionize the way collaborative work in global health is organized.
As you are about to discover, we will move increasingly to a model whereby experts will be able to showcase their contributions better (thanks to the fact that we will better measure respective contributions of each expert). Setting up this new model will take us at least two years. It is innovative and potentially disruptive, so risk and uncertainty are unavoidable. The pilot stage will be crucial. The NORAD project is designed in such a way that the PBF CoP will spearhead the innovation. So, stay tuned to this blog for the months to come. You will soon find out that you will have a key role in the success of this exciting new endeavor.
But now, let’s take a moment to celebrate and congratulate ourselves for what we have achieved together in five years. Feel free to leave a comment at the bottom of this blog. More in particular, we would like to know from you how you have experienced these five years. What changes have you witnessed in your country, as far as PBF is concerned? How has the CoP assisted you during this period? These testimonies will continue to inspire us…
