Enhancing Healthcare Through Performance Based Financing: PBF Rungwe Pilot Project Tanzania 2010-2012

1. Christian Social Services Commission (CSSC) An Ecumenical Body of Tanzania Episcopal Conference and Christian Council of Tanzania Performance Based Financing PBF Rungwe Pilot Project Tanzania 2010 – 2012 PBF Conference 14-17 February 2011 – Bujumbura-Burundi by Sule, T.Michael- Zonal PBF Coordinator

2. Presentation Outline • Introduction • Over- all objective • Specific Objectives • Expected Results • Project achievement • Challenges and solutions • Way forward

3. Introduction • PBF Rungwe Pilot project part multi-country Network implemented in 7 Africa countries: Rwanda, Burundi, DRC, CAR, Cameroon, Zambia and Tanzania • European Union (EU) supports Project via Cordaid • 3 years PBF - Pilot Project in Rungwe District - Tanzania as a model to be replicated to other districts at a later stage. • Focus to shift approach in health financing from input to output based financing.

4. Project objectives The overall objective • To improve the functioning of the health sector through an active exchange of the experiences of the PBF approach in 7 countries Specific objectives - Create an international network of exchange between 7 countries • Learning through action research • Capacity building partners of Cordaid and other key stakeholders (LGA, Health authorities) to manage PBF • Promote community participation in relation to two systems of funding(PBF and insurance) and experiment with synergetic activities

5. Project expected results • There shall be a Tanzanian Training institute capable of giving training in PBF • CSSC independently capable of promoting and expanding experiences on PBF • Harmonization of PBF approach between church and government, through joint development of Service Agreements in Rungwe District • The Voice of Customer is strengthened

6. Project achievement (1) There is a Tanzanian Training institute capable of giving training in PBF –at KCMC • KCMC has trained 20 health care workers and administrators on PBF theories and practices CSSC independently capable of promoting and expanding experiences with PBF through • training of staff on PBF(TOT) • PBF forum established in the district for sharing PBF project progress, information and experiences

7. Project achievement cont…(2). • Harmonization of PBF approach between church and government, through joint development of Service Agreements in Rungwe District • PBF inception meeting held between stakeholders in Rungwe for info sharing and project introduction • District PBF forum at district level in place and active by conducting biannual meetings. • Training of 6 HFs staff on strategic planning • Lobbying for the signing of SA between the Council and FBO health facilities started.

8. Project achievement cont…. (3) • The Voice of Customer is strengthened • 12 HFs have established Facility Governing Commitees and trained on roles and responsibilities • Community representatives trained on strategic plan development for Health facility

9. Challenges & proposed solutions • Delayed process for development of SA Proposed solution: Continued discussion –CSSC with stakeholders • Lack of funding for the motivation of health workers (No motivation package). Proposed Solution: CSSC will lobby LGA to include motivation package in their budgetary Plans • The project covers only FBO health facilities that are fewer compared to Government the impact might not be significant Proposed solution: PPP initiatives in whole district

10. Wayforwad • Implementation of second year PBF • Involving government facilitiesin PBF • Engaged in Action Research

11. Thank you for listeningAsanteni sana