Recommendations for DRC from the Bukavu PBF course

The 63rd PBF course took place in Bukavu from 9 to 21 October. Hereby the course report (rapport du cours).

There were 19 participants from the DRC (16), the Republic of Congo (2) and the Central African Republic (1).

The course was a success. The action plans proposed by the working groups are of a high standard. The course had relatively few participants (19), which allowed for intense exchanges between the participants and the facilitation team. This was appreciated by the participants and their satisfaction with the facilitation was 90% and their satisfaction for participation was 93%. The economics module was considered difficult by a large part of the participants. We regret that economics and health economics is not considered important in the curriculum of most health sector training institutes. We consider this to be a major challenge in making health systems more efficient. Several participants also indicated that the indices management tool module requires more time. Another wish of the participants was that it is necessary to develop a PBF course more specifically for the PBF in the administration sector.

  The 19 participants to the PBF course in Bukavu

The presence of Dr. Paul Pilipili Hangi and Dr. Claude Ntabuyantwa of the PBF Unit from Kinshasa was a great asset to share their national experiences as well as to discuss the challenges of the PBF system in the DRC.

The course produced two distinctions and the average posttest result was slightly above the scores of previous PBF courses.

Strengths and challenges of PBF in the DRC

PBF in the DRC covers 27.5 million (= 35% of the total) inhabitants with World Bank funding of US $ 390 million for the period 2015-2019, which corresponds to $ US 3.00 per person per year. There are 169 Health Districts covered by the PBF program and the PBF provinces have created CDV Agencies (Contract Development and Verification Agencies). The program supports 180 hospitals and 2,818 primary health facilities and is the largest PBF program worldwide.

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The 60th PBF course in Cotonou

The 50 participants

The 60th PBF course was held in Cotonou from 21 August to 1 September 2017 with 50 participants from Chad (17), Guinea (11), Senegal (7), Côte d’Ivoire (4) , Burkina Faso (4), Cameroon (3), Niger (3) and Congo Brazzaville (1).

Hereby the details course report (rapport du cours)

The demand for the 60th course in Cotonou was so high that we had to refer several participants to the next PBF courses in Bukavu October 9th (announcement), Mombasa November 20th (announcement) and Cotonou January 8th, 2018 (annonce). Due to the high number of participants, it was, therefore, difficult to satisfy the expectations of all participants during the plenary sessions and at the same time to finish all course modules. This course ended on Friday instead of on Saturday and there were high-level decision makers among the participants that demanded attention during the plenary sessions. These factors combined explain why during the evaluation the methodology and the timekeeping criteria scored lower than in previous courses and that the final exam result of 68% was slightly below the previous course averages. Continue reading

PBF in Gabon

Gabon aims to start in early 2018 a new PBF program that will cover a substantial number of regions. Preparations are still under way with the government and the World Bank about the size and the scope of the program. A particularity of this PBF program is that it aims to integrate and strengthen the existing obligatory insurance program, which is suffering from cost-overruns, moral hazard, quality assurance problems and verification problems. Preparations for the PBF program have started during 2017 with a feasibility study, a mapping and rationalization exercise of catchment areas, a two-day seminar with decision makers and, two 14-day PBF courses with in total 70 health professionals.

The second International PBF Course (the 62nd in total) was held in the Solf Hôtel in Lambaréné from the 10th to the 22nd of July 2017. Forty participants took part with eight facilitators and one staff dedicated to the Secretariat. All participants were of Gabonese nationality. 39 participants took the final test of the course and there was 1 distinction of 90% and 3 participants scored 87%.

Hereby the course report (rapport du cours).

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The 61st PBF course in Ngaoundéré


The 50 course participants with their Certificates in the Presence of the Governor

The 61st international PBF course was held at Mentong Palace Hotel in Ngaoundéré, from June 19 to July 1, 2017.

Download the detailed course report (rapport du cours)

The main objective of the course was to extend the PBF reform approach in the northern part of Cameroon and notably in the Regions of Adamaoua, North and Far North with in total 7 million inhabitants. These regions have the poorest reproductive health indicators in the country.

The course was marked by the participation of three executives of the Ministry of Civil Registration (BUNEC) from the central level and the Secretary Generals of three Town Halls in Adamaoua Region. The other participants were from the health sector.

The evaluation of the course showed that the course was a success. There were nine distinctions of participants with scores of 90% or more for the final test.


PBF recommendations for seven countries attending Mombasa course

The 26 participants of the June Mombasa course

The 59th performance-based financing (PBF)  took place in Mombasa, Kenya from Monday May 22 to Friday June 2, 2017.

Hereby the detailed course report.

The next English PBF course will take place also in Mombasa from November 20 to December 2.

The next open French PBF course will take place in Cotonou, Benin from August 21 to September 1, 2017.

In general, the PBF course in Mombasa was a success. All participants passed the final exam and the seven country groups produced impressive action plans (see below). The Sai Rock Hotel at the Mombasa beach is an attractive venue to learn and to think about how to improve health systems in the respective countries represented. The main lessons learned concerning the course were that we should continue to condense the course content with key messages, that we should further discipline the debates, make the PowerPoint presentations shorter and to allow for more group work.


The PBF course welcomed participants from seven countries Cameroon, Ethiopia, Lesotho PBF program, Nigeria, South Sudan, Uganda and Zimbabwe. The facilitation team consisted of Godelieve van Heteren, Fanen Verinumbe, Claire Rwiyereka and Robert Soeters. We also welcomed Nicolas de Norman, the director of BlueSquare, who enlightened us with his very spirited vision about the data collection and the integration of PBF within the DHIS2 system. Throughout the two weeks of the course, the country teams engaged in drafting and improving their action plans on how to implement and advance PBF in their countries.

View from the conference Hotel

The daily evaluations resulted in above average scores compared to previous courses. The methods and facilitation and participation and time keeping was above average, while the Hotel services this time was below average.

PBF course content and program materials have expanded considerably since the first course in 2007. Our aim has always been to cover all modules during the 12-days course, but this has become increasingly unrealistic with the new developments and instruments in PBF. The starting level of each participant is also different: some are novice in PBF while other’s have already PBF knowledge and come to the course with specific objectives. Therefore, we try progressively to condense the messages in order to gain time and to tailor the content of the course as much as possible to the needs of each participant. The weight of the exam has considerably increased since 2015. As a result, 11% of the participants during the last 9 courses in 2015-2016 did not pass the threshold of 55% compared to 5% during the previous 8 courses in 2014-2015. Yet, in this Mombasa course all participants manged to pass the exam for which we present our congratulations.


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