Afghanistan

Start: 2003 and 2012
Phase: RBF initiatives nationwide
Coverage Estimate: RBF 100%, PBF applied in Urozgan Province
Feasibility: Reasonable
Supported by: MOH; WB; Cordaid

Description: RBF or general contracting through NGOs was introduced since 2002. However, this is a Performance Based Contracting approach with centralisation, limited autonomy of health facilities and no contracts with private health providers. NGOs tend to mix the roles of CDV Agency, financing and provision. A successful “pure” PBF pilot was conducted by Cordaid in Urozgan province in August 2012, with encouraging results.

References:
Amelli, O. and W. Newbrander (2008). “Contracting for health services: effects of utilization and quality on the costs of the Basic Package of Health Services in Afghanistan.” Bulletin of the World Health Organization.

Arur, A., D. Peters, et al. (2009). “Contracting for health and curative care use in Afghanistan between 2004 and 2005.” Health Policy and Planning.

Loevinsohn, B. and G. D. Sayed (2008). “Lessons From the Health Sector in Afghanistan: How Progress Can Be Made in Challenging Circumstances.” JAMA 300(6): 724-726.

Loevinsohn, B. (2008). Performance-Based Contracting for Health Services in Developing Countries: a toolkit. Washington DC.

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