MFAN & Management Sciences for Health on Performance-Based Financing

On Wednesday morning, MFAN co-hosted an event with Partner Management Sciences for Health (MSH) examining the impacts and implementation of performance-based financing (PBF) for global health services. A panel of experts, moderated by MSH performance-based finance Advisor Kathy Kantengwa, discussed the thinking behind PBF and shared some success stories. More efficient HIV/AIDS programming in Rwanda (described in the video below) is a prime example:


Oscar Picazo, a health economist who has worked with USAID and the World Bank in the Philippines and elsewhere, described performance-based financing as an “approach to financing that focuses on the achievement of measurable outcomes.” Offering flexible strategies and implementing programs at macro, institutional, and individual levels, PBF incorporates global health supplies and demands to maximize returns.

The panel’s overview of results-oriented funding aligns nicely with the discussion of innovative financing at a February event co-hosted by MFAN. Performance-based financing also drives many of the principles laid out in MFAN’s new policy agenda, From Policy to Practice: Pamela Rao, Senior Health Systems Strengthening Officer at USAID’s Office of HIV/AIDS, linked “payment for performance” (P4P) initiatives to efficiency, accountability, and local ownership.

Gyorgy Fritsche, Senior Health Specialist with the World Bank, highlighted the importance of monitoring and evaluation, saying that PBF demands verification, not a “business-as-usual strategy.” Daniel Kraushaar, MSH’s Principal Technical Advisor for Health Systems, agreed on the need for evidence to evaluate performance-based financing and offered some data as examples. Liberia, for one, has seen improvements in its maternal health indicators thanks to performance-based contracting.

Performance-based financing has the potential to increase funds and autonomy for healthcare providers throughout the developing world. Today’s event underscored the need for country-wide, multi-level solutions led by local actors that offer long-term visions with increased accountability. Performance-based financing will rely on consistent evaluation as it assesses past programs and develops strategies for the path forward.

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