The 58th International PBF Course was held at Makèpe Palace Hotel in Douala from 6 to 17 March, 2017.
Hereby the course report.
Forty-seven participants took part in this course with six facilitators and three staff dedicated to the Secretariat. Thirty-six participants were from Cameroon, three from Central African Republic, two from Burkina Faso, two from Côte d’Ivoire, 1 from Republic Congo, 1 from Democratic Republic of Congo, 1 from Chad and 1 from Switzerland.
In general, the international PBF course in Douala was a success. 88% of the participants said that the course met their expectations and 91% of them appreciated the teaching materials. The reception by the facilitation team was appreciated by 89% of the participants. The action plans of the 14 working groups were generally of high quality compared to previous courses. Yet, the number of modules and exercises to be shared has increased sharply in recent years and, as a result, 42% of participants said the time for the course was too short. The course facilitation will also have to make difficult choices on which modules to share with each individual participant and how to organise this modular approach adapted to the needs of each participant.
Cameroun: Assure the regular payments of PBF invoices by the national PBF Unit. Payment delays are often between 6 and 12 months, which have put at risk the progress of the PBF program and has frustrated all actors, but especially those who depend for a large extent on the PBF subsidies such as the regulatory authorities and the CDV Agencies. At health facility level, this also applies for those activities that are offered free-of-charge to the population such as the support for the vulnerable, home visits, tuberculosis treatment and family planning services. Performance contracts with the national PBF Unit may solve these delays and this should already start in April 2017. New delays in the payment schedule most have consequences for the variable part of their remuneration. The directorates of the MOH should also be put under performance contracts starting from the 1st of April in at least one directorate.
- Improve the economies of scale of the operations of the district health management teams. Districts should be rationalised into health district units covering around 150,000 people. This implies cutting certain large health districts such as Deïdo in Douala with a population of 800,000 into at least three new health districts. Other districts should be given a principal contract whereby they supervise those districts, which have less than 40,000 population. In the small districts, the medical doctor may concentrate on the hospital activities and leave the regulatory role to another medical doctor operating from another larger health district. All this also to avoid conflicts of interest.
Set up urgently the CDV Agency for the Central Region with a technically well-equipped team recruited on the basis of competence and competition. In the legal sense, the CDV Agency should be under the umbrella of the Regional Fund for Health Promotion, but it should have a large degree of autonomy to avoid any potential conflicts of interest with the RFHP and notably concerning the distribution of drugs.
- Encourage Regions and CDV Agencies to make the most effective use of their PBF action research budget. Research topics should be identified and discussed during district validation meetings. The research budget should be made available to any actor capable of conducting quality research and could include health facility staff, regulators, members of public health schools. Moreover, it is encouraged that regions seek collaboration with international research institutes to further enhance the quality of their action research.
- Ensure the autonomy of the PBF health facilities by applying derogations for: (a) Authorizing health facilities to open separate commercial bank accounts, which they also control; (b) Applying the market price for the purchase of inputs instead of the higher mercurial prices and; (c) Authorizing health facilities to purchase their inputs from accredited distributors operating in competition.
- Encourage the quick introduction PBF in the Education sector in Cameroon and support the action plan of the Education sector group in Douala.
- Several country teams in the course (Burkina Faso, Chad, CAR (Bekou Fund), DRC, the Republic of Congo and Ivory Coast) propose that the design of their PBF interventions should improve and include more PBF best practices. Details can be found in the follwong paragraphs.