Start: 2006
Phase: Started in 2006 in 3 provinces – gradually expanded to national scale in April 2010
Coverage Estimate: 100%
Feasibility: High
Supported by: MOF/MOH; WB; EC; CTB/BTC; Cordaid; GAVI; Bilateral partners

Description: Burundi was the second country in Africa after Rwanda that rolled out PBF country wide in 2010. The design was slightly different from usual designs that free health care indicators for small children, pregnant women and deliveries were added to the package. This was a political compromise whereby the government financed around 50% of the PBF program. The political crisis in 2014 negatively affected the PBF program so that during several months PBF subsidies were not paid. Yet from 2016 onwards those problems were solved and payments again became regular with an adapted financing mechanism.


Bonfrer, I., Soeters, R., Van de Poel, E., Basenya, O., Longin, G., van de Looij, F. (2014). Introduction of Performance-based financing in Burundi associated with improvements in care and quality. Health Affairs.

Bonfrer, I, Van de Poel E, Van Doorslaer, E The effects of performance incentives on the utilization and quality of maternal and child care in Burundi. Social Science & Medicine 123 (2014) 96-104.

Falisse, JB, Ndayishimiye, J, Kamenyero, V, Bossuyt, M Performance-based financing in the context of selective free health-care: an evaluation of its effects on the use of primary health-care services in Burundi using routine data. Health Policy and Planning 2014; 1–10

Bertone, M. P. and B. Meessen (2010). “Splitting Functions in a Local Health System: Early Lessons From Bubanza and Ngozi Projects in Burundi.” The Hague, Cordaid.

Falisse, J.-B., B. Meessen, et al. (2012). “Community participation and voice mechanisms under performance-based financing schemes in Burundi.” Tropical Medicine and International Health (in press)((in print)).

Nimpagaritse, M. and M. P. Bertone (2011). “The sudden removal of user fees: the perspective of a frontline manager in Burundi.” Health Policy and Planning 26 (Supplement 2): 63-71.

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