History: PBF started in 2007 in the East Region by Cordaid and the Catholic Bisdom of Batouri. The next phase started in 2011 in Littoral Region and in 2012 in North-West and South West regions. By 2019, PBF covers 10 regions and 70% of the country and by 2020 PBF will be rolled out nationwide among 24 million people.

Coverage Estimate: 70%

Feasibility: High

Supported by: Ministry of Health, Ministry of Finance, Regional Funds for Health Promotion, World Bank, UNICEF, UNFPA, GAVI, Cordaid

Description: The PBF program in the Littoral Region is the first urban PBF program in the world with interesting innovations such as (1) Verification by telephone; (2) Targeting the vulnerable by paying two levels of subsidy – one for ordinary patients and another 4x higher for vulnerable patients; (3) The community indicator “home visit of at least 30 minutes following a protocol” covering social marketing issues such as nutrition, hygiene promotion, use of latrines, use of family planning and immunisation. (4) An internal PBF program of departments being autonomous and signing contracts with the general directorate of the tertiary referral hospital HGOPY without external subsidies (“the black box within the black box”).

The three northern regions started PBF in 2016. Two impact studies (one in Littoral Region and another in SW, NW and East regions) were conducted during the intervention with such encouraging results that the government decided for the national scale-up of PBF as the best approach to achieving Universal Health Coverage.