Willy Janssen1, Jean de Dieu Ngirabega2, Michel Matungwa3, Stefaan Van Bastelaere4. 1. MD, MPH, International Technical Assistant, Belgian Development Agency BTC, Rwanda. 2. MD, MPH, MSc, PhD, Head of Institute of HIV/AIDS, Disease Prevention & Control. Rwanda Biomedical Center, Rwanda. 3. MPH, PBF M&E Expert, Ministry of Health, Rwanda. 4. MD, MMed, MPH, Senior Health Expert, Belgian Development Agency BTC, Rwanda, Belgium stefaan.vanbastelaere@btcctb.org.
Abstract
INTRODUCTION: Since 2000 performance-based financing (PBF) made its way to sub-Saharan health systems in an attempt to improve service delivery. In Rwanda initial experiences in 2001 and 2002 led to a scaling up of the initiative to all health centres (HC) and district hospitals (DH). In 2008 PBF became national strategy. METHODS: PBF was introduced in Rwanda in 2006 at the DH level. Evaluation on their service delivery was carried out quarterly in the following areas: hospital management, support to the health centres and clinical activities. We studied four DHs. RESULTS: After 5 years, an improvement in the quantity of clinical activities was observed, as well as quality in hospital management, in HC support and in clinical activities. CONCLUSION: PBF proves to be a promising approach in strengthening and maintaining quality service delivery in the sub-Saharan district hospitals.
INTRODUCTION: Since 2000 performance-based financing (PBF) made its way to sub-Saharan health systems in an attempt to improve service delivery. In Rwanda initial experiences in 2001 and 2002 led to a scaling up of the initiative to all health centres (HC) and district hospitals (DH). In 2008 PBF became national strategy. METHODS: PBF was introduced in Rwanda in 2006 at the DH level. Evaluation on their service delivery was carried out quarterly in the following areas: hospital management, support to the health centres and clinical activities. We studied four DHs. RESULTS: After 5 years, an improvement in the quantity of clinical activities was observed, as well as quality in hospital management, in HC support and in clinical activities. CONCLUSION: PBF proves to be a promising approach in strengthening and maintaining quality service delivery in the sub-Saharan district hospitals.
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