The 60th PBF course in Cotonou

The 50 participants

The 60th PBF course was held in Cotonou from 21 August to 1 September 2017 with 50 participants from Chad (17), Guinea (11), Senegal (7), Côte d’Ivoire (4) , Burkina Faso (4), Cameroon (3), Niger (3) and Congo Brazzaville (1).

Hereby the details course report (rapport du cours)

The demand for the 60th course in Cotonou was so high that we had to refer several participants to the next PBF courses in Bukavu October 9th (announcement), Mombasa November 20th (announcement) and Cotonou January 8th, 2018 (annonce). Due to the high number of participants, it was, therefore, difficult to satisfy the expectations of all participants during the plenary sessions and at the same time to finish all course modules. This course ended on Friday instead of on Saturday and there were high-level decision makers among the participants that demanded attention during the plenary sessions. These factors combined explain why during the evaluation the methodology and the timekeeping criteria scored lower than in previous courses and that the final exam result of 68% was slightly below the previous course averages.

Despite these limitations, we believe that the impact of the 60th PBF course has been very high and this is shown by the quality of the action plans of the 8 country groups, which will be added to this website next week. Yet, during future courses, we will end the course on Saturday, we will better discipline the discussions, focus more on the key messages and we intend to limit the number of participants.

Five participants obtained a distinction, which we put this time at 87% instead of 90% due to the relatively low score of 68% for the overall average result of the final test.

We congratulate the following persons:

  • With 87%: Dr. Samuel OHOUO BROU, Coordinator CTN. – FBR, Ivory Coast
  • With 87%: Ms Geneviève NSIELA SUH, South West CDV Agency, Cameroon
  • With 87%: Dr Leticia SAKANA, Center Muraz, Burkina Faso
  • With 90%: Ms Aminata MBODJI, Adviser in the Ministry of Health, Senegal
  • With 90%: Dr. Fadima YAYA BOCOUM, IRSS researcher, Burkina Faso.



  1. Advocacy at the highest level to:
  • Expand the number of accredited distributors for inputs;
  • Improve the health facility procurement procedures;
  • Make exemptions to allow providers to buy from distributors operating in competition;
  • Share the action plan with the authorities, the partners and other implementing actors;
  • Implement the Cotonou action plan;
  • Provide the opportunity for other members of the RBF Unit and Directorates of the MOH to attend the International RBF courses;
  • Provide members of the RBF Unit the opportunity to study the experiences in other FBR countries (Cameroon, Burundi, Rwanda …).
  1. Revise the RBF manual :
  • Broaden the number of primary and hospital level indicators;
  • Include a baseline study for the PBF program to review progress;
  • Develop a standard business plan and indices management tool;
  • Review the roles and set-up for the verification institutions (AVI or CDV Agency)
  • Respect the PBF principle of the separation of functions
  • Incorporate the activities of the Universal Health Insurance into the implementation of the FBR approach.

Fish catch at the Cotonou beach


  • Mobilize financial resources to ensure the linkage of the RBF with the targeted free health care for the RBF zones;
  • Strengthen the institutional set-up of the RBF Technical Unit and the Free Health Care Unit in the MOH and facilitate the collaboration with the other directorates when revising the organizational chart of the Ministry of Health;
  • Carry out operational research to support the development and implementation of the “marriage” between the RBF program and the Targeted Free Health Care policy of the MOH;
  • Advocate that the key FBR principles are allowed to be respected in the RBF health facilities.


  • Review the RBF program with the aim to achieve a score of at least 80%. This should include the granting of autonomy for the health facilities;
  • Advocate for the opening of PBF budget lines in the national budget;
  • Introduce a national technical PBF Unit with the personnel required for its operation;
  • Organize a roundtable meeting with the partners to mobilize fresh funds to ensure the financing of RBF in all district of Tillabéri Region;
  • Map the public, private and religious health facilities in the PBF areas and sign performance contracts with them;
  • Ensure the training of all actors involved in PBF;
  • Set up a PBF network in Niger.


  • Advocate for the increase of the health sector budget and transform (already existing) input budget lines towards PBF performance budget lines;
  • Advocate with the highest authorities for the liberalization of distribution channels;
  • Liberalize cost recovery tariffs for health facilities;
  • Separate functions at all levels;


  • Organize the restitution-, information sharing and advocacy meetings about the PBF approach with administrative-, traditional- and religious authorities.
  • Train all actors involved at the regional level in PBF;
  • Train and equip health facilities with management tools;
  • Organize the health facility quality reviews on a quarterly basis. Supervise audits at different levels of the health system


  • Restitution of the main conclusions of the action plan written in PBF in Cotonou with the relevant health authorities;
  • Establish a Task Force composed of national resource persons to support the PBF program;
  • Complete the package of activities for the primary MPA and hospital (CPA) levels;
  • Search for PBF financing (of at least USD 4 per year per capita);
  • Develop and implement a human resource capacity building plan;
  • Scale up the PBF program in Guinée
  • Advocacy for the revision of the regulatory texts (reform of the health system, civil service, finance, budget, etc.).
  • Develop an operational work plan to:
  • Continue the FBR pilot and its extension into a PBF program in the Mamou region and in new areas;
  • Identify key activities for the implementation of the performance-based funding program.


  • To the Ministry of Health and the national PBF unit (CTN-PBF): Advocate that the Ministry decentralizes the human resource management and that the PBF program pays more timely the PBF subsidies ;
  • To the faith-based authorities: Ensure the autonomy of their service providers;
  • To the service providers: Apply the indices management tool with the orientation to include all revenues including cost-sharing in the common basket ;
  • At the CDV Agency: Start implementing the Quality Improvement Bonuses (BAQ) or investment units for the improvement of the infrastructure and equipment of health facilities.


  • Advocate with the government to increase its contribution share towards PBF from the current 20% to 40%;
  • Advocate with technical and financial partners to increase their contribution;
  • Establish a common basket of financial contributions from the government and all financial donors;
  • Advocate for the integration of the Univeral Health Insurance program and the Free Health Care program into the PBF program approach;
  • Integrate the indicators of home visits following a protocol and the Quality Improvement Bonuses into the primary level health package ;
  • Prepare a regulatory text for the abolition of the principle of “Unicité de Caisse”, which obliges health facilities to transfer all their cost-recovery revenues to a treasury account;
  • Draw up a text on how to manage autonomously the resources of health facilities;
  • Develop and adopt regulatory texts enabling health facilities to recruit their staff;
  • Create a framework for the liberalization of the distribution of drugs and other inputs.
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