Title:
One Year Performance Based Financing Experiences in Zanzibar, Tanzania: the case of West and Mkoani PBF Pilot Districts
Authors:
Abdalla, Omar Ali
Year:
2015
PAGE:
79
Language:
En
Subject:
Health and Poverty
Keywords:
Zanzibar, Performance-based Financing, Quality, Utilization
Abstract:
The Zanzibar (Part of United Republic of Tanzania) health status is relatively low and its health system like some other Sub-Saharan Countries doesn’t perform well to reach the MDGs for some of the indicators by the end of this year. In July 2013, to boost its health system performance the Ministry of Health Zanzibar institute implemented PBF in two districts, selecting 24 primary health care units for control. At the end of 2014 some positive results were shown and claimed to be attributed by the pilot, which led to the plan to scale up the project. In this study we aim to review a one year implementation of PBF in Zanzibar by examining the history and design of PBF in Zanzibar, analysing the effectiveness of the project in terms of quality by utilizing index indicators, and exploring experiences of PBF in some other Sub-Saharan countries. The study used secondary data from routine verification to determine the effect. The statistical techniques used for analysis were Difference in Difference and time series . This study reveals that the adherence to treatment guidelines improved by 300% in the intervention districts. Further, in comparison to control facilities PBF has shown improvements in increasing institutional delivery (18%), immunization Penta3 (10%) and first ANC visit within 16 weeks (10%). The filling of partogram has been increased by 60%. However the number of outpatients per capita remains 0.5 and the PBF showed no effects on family planning consultation. PBF in Zanzibar has shown promising results in some of the analysed indicators, though the scheme contains certain risks like distortion, gaming, coercion and decreased sustainability, which need to be addressed. Also the design and one year implementation of PBF has caused important components of PBF to be left out, including compiling of the business plan and the separation of responsibilities between provider, purchasing agent and the regulatory party. All these components need to be put in place in order for improving accountability.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institue)
Department:
Development Policy & Practice
Country:
Tanzania, United Republic of
Region:
Eastern Africa
Training:
Master of Public Health / International Course in Health Development (ICHD)
Category:
Research
Right:
© 2015 Abdalla
Document type:
Thesis/dissertation
File:
bkdDQwUlTl_20161026125352199.pdf