How many countries and people benefit worldwide from PBF – RBF in 2019?

This posting describes the status of PBF, RBF or strategic purchasing (a term preferred by WHO) worldwide.

It is possible that some information in this posting may not be correct, that it is outdated or that we excluded countries that do apply PBF or performance-type reforms.

We would highly appreciate if those, with more information or corrections about the current situation, would drop an email  to

Please consult the country overview that presents the countries in alphabetical order.

Our findings are based on the feedback from the participants to previous PBF courses and we consulted World bank Project Appraisal Documents of the World Bank as well as other publications available in the public domain.


  • In 12 countries (17%) PBF has become national policy. From those Cameroun and Burundi have the most “PBF pure” designs.

Continue reading

PBF in seven Sahel countries, Rwanda and education

The 29 participants in Benin

We report on the PBF programs in seven Sahel countries and on the recent developments in Rwanda, which was the first country in Africa that started PBF in 2001 and scaled it up in 2005. We also report on PBF in the education sector in the Central African Republic.

This was the last of 10 PBF courses in 2018 organized by SINA Health with different partners. The Cotonou course took place from the 3rd to the 15th December 2018 with 29 participants from eight countries: Senegal (10x), Mauretania (5x), RCA (3x) Niger (3x), Chad (3x), Cameroon (3x) Mali (1x) and Rwanda (1x). The course was organized by BEST-SD in Benin with the assistance of BASP-96 from Burkina Faso.

The daily evaluations of the course averaged 82%, which is 3.5 points above the average of the 43 previous Francophone courses.  The impact of the 75th PBF course has been translated into a good quality of the action plans carried out by the groups of countries (see rapport final du cours).

Twenty-nine participants did the posttest and the average progress compared to the pre-test was 29%. The average score of the post-test was 74%. Eight participants obtained a certificate of distinction with a score of 87% or higher and two participants obtained a certificate of participation of 50% or lower.

Country recommendations Continue reading

The scaling-up of PBF in Nigeria – Mombasa report

La version française du posting est aussi disponible sur ce site.

The next English PBF course is in Mombasa Monday, April 1 to Saturday 13, 2019.            The next French PBF course is in Cotonou Monday 3 to Saturday 15 December 2018

The 36 participants to the 74th PBF course with the First Lady of Kilifi County

The 74th performance-based financing (PBF) course took place from Monday, October 29th to Friday, November 9th, 2018, in Mombasa, Kenya. Thirty-six participants attended the course: 34 from Nigeria, 1 from Liberia, and 1 from Cameroon.

Hereby the full course report.

Continue reading

The opportunities for PBF in the DR of Congo

The 60 participants of the 75th PBF  course with theSecretary-General

The 75th  International PBF Course took place from 8 to 20 October 2018 in Kinshasa in the Democratic Republic of Congo, bringing together 60 participants from the central level.

Hereby the report of the course (rapport)

The health status of the population in DRC is not well. Maternal mortality and malnutrition rates are high.  There are multiple problems in reproductive health such as complications and consequences of early and unwanted pregnancies. It is further aggravated by the occurrence of pregnancies that are too close together due to the low contraceptive prevalence of 8%. There is still no convincing strategy for involving the private sector in the health system. Continue reading

New developments with results-based financing in Guinea

The 47 participants with the Minister of Health

The 74th International RBF course was held in Coyah in Guinea from the 10th to the 22nd of September 2018. There were 43 government participants from the central, regional and district levels, three representatives of partners organizations and one representative from the private sector.

The impact of the 74th RBF course has been reflected in the good quality of the group action plans (see rapport). The average pretest score was 32% and the post-test score was 62%  which means a 30% improvement. Three participants obtained a favorable mention for their final test with a score of 83% : Dr. Ahmed Sekou Tidiane BARRY of the Ministry of Health – DNESH ; Dr Moussa SOUMAH                                 of the Ministry of Health – SNAS and ; Dr. Houssainatou BAH from the District Health Directorate Dubreka. Continue reading