Zimbabwe

Start: 2011
Phase: Pilot started in 2 districts
Coverage Estimate: 80%
Feasibility: High
Supported by: MOH/MOF, WB; Global Fund, Cordaid;

Description: Pilot started with WB financing and Cordaid implementation. The program upscaled in 2015 to all rural districts in Zimbabwe covering approximately 80% of the population. An impact evaluation was part of this program and showed favorable results. In the beginning there were several questions about the PBF approach (such as limited autonomy; limited ability to procure drugs; no gainsharing by staff). Yet, the government has pro-actively taken up PBF and the PBF design is gradually improving. While it may still be argued that it is better for governments to start “pure” PBF programs some argue that the Zimbabwe example shows that sometimes a more gradual step-by-step introduction of PBF approaches may also work if this is politically required. There is strong support from the Government, and full ownership. A new phase of the program in 2017 may also include Global Fund financing.

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