Phase: Scaling up
Coverage Estimate: 25% extension towards 60% in 2018
Feasibility: Medium to good
Supported by: MOH; BM; PADS
Description: PBF started in 2010 with financing from the World Bank. There were several design issues and the second phase of the PBF program started in January 2014 for 4.4 million people and 15 health districts with a more pure approach. The second phase of the PBF program applies a targeted poverty approach whereby health facilities are reimbursed for treating vulnerable patients free of charge or at the nominal cost. The overall results of this phase of the program are encouraging.
Yet, there remain concerns about the sustainability of the PBF program due to: (1) Changes in government policy ; (2) Mixing PBF with expensive and low-quality Free Health Care and ; (3) The abandonment the Regional Contract Development and Verification Agencies operated by local NGOs; (4) The PBF Project Management Unit (PADS) was not integrated into the Ministry of Health. 2017 will, therefore, be crucial in how far PBF will be upscaled to the whole country or that the PBF program will discontinue or downsized to a non-pure version.
The government signed in mid-2018 an agreement with partners to scale up RBF with targeted free healthcare towards 6 out of 10 regions.