The 83rd PBF course in Ndjamena – Tchad

The participants and facilitators of the PBF cours

We are pleased to announce that the Ministry of Public Health and National Solidarity of Chad started on September 13, 2021, a 2-week PBF course with 35 participants from the Ministry of Health, the Ministry of Finance and Budget, the Ministry of Planning, the Inter-ministerial Unit for Universal Health Coverage, 2 NGOs and the organisation INSEED. The latter will in future play the role of contracting and verification agency.

We will update this website during the course to keep everyone informed of the progress of the course. This course will be the first of five 2-week courses in Chad with the aim of creating the capacity to start by the end of 2021 a new 4-year phase of the Performance Based Financing program in Chad with a budget of USD 116.5 million, funded by the World Bank.

Recommendations for 6 countries from the 82nd PBF course in Cotonou

All participants successfully passed the post-test ! Congratulations

The last FBP course of 2019 took place in Cotonou from December 2 to 14, 2019 with 32 participants from six countries (Mali, Comoros, Gabon, Mali, Niger, DRC and CAR). Eight groups (three groups from CAR) developed excellent action plans, which, if they are implemented, will greatly advance PBF in the respective countries and sectors.

Here the detailed report of the course (rapport).


  • In the CENTRAL AFRICAN REPUBLIC around 50% of the population is covered with PBF, and the government decided to roll out to 100% the reforms nationwide by the end of 2020 with funding from the government, the World Bank and the European Union. NGOs such as Premiere Urgence Internationale – which attended the Cotonou course – may also start playing an active role. In the DEMOCRATIC REPUBLIC OF CONGO, the PBF reforms are progressing well and 40% of the population is covered by PBF. The designs in CAR and DRC are relatively “pure” in terms of the application of the PBF best practices. However, the participants from these two countries in Cotonou also propose several improvements in the design.
  • In the COMOROS, 50% of the country is covered with PBF and the country is proposing to scale up in 2021 towards a “purer” PBF design compared to the current one. The six participants in Cotonou in their action plan proposed several improvements in the design and will advocate for a larger ownership for PBF among key decision makers.
  • In GABON, the planning for performance-based financing started in early 2017 with Gabonese funding, but implementation has not yet started. This may be due to a lack of clarity on the financial procedures and willingness by government to provide the funds. The Ministry of Finance in Gabon aims to launch a pilot PBF program and could also help the Ministry of Health to progress with PBF.
  • MALI has experienced long delays in starting the scale up of PBF despite that two pilot projects have shown excellent results. Yet, the Mali government with support of the World Bank, the Dutch government and GFF now aim to start a large relatively “pure” PBF pilot in 2020 for 5.8 million people and a budget of $ 66 million for four years. A large team of 14 people from Mali was in Cotonou to improve the design of the program.
  • NIGER also experienced long delays in starting the scaling up of PBF despite that the pilot project has shown excellent results. The reasons for the delays are: 1. A lack of ownership for PBF by the decision-makers. PBF remained in the “project mode”; 2. Delays in the effective integration of the National Technical PBF Unit in the Ministry of Health; 3. Errors in the design of the PBF program. The Niger participants in Cotonou aim to revive PBF with the start of a large pilot programme.
  • In the Central African Republic, the MINISTRIES OF JUSTICE AND THE INTERIOR with support of Cordaid aim to launch a PBF program. Experience in other countries with PBF in these sectors such as in the DRC have shown good results.

Image de temple de pitons de Ouidah

A problem in many countries is that PBF budget lines are not effectively integrated in the government budget and Finance Law procedures.

There may be a lack of clarity regarding the financial and legal procedures required to disburse the government budget through performance payments directly towards peripheral providers and the population instead of through the classical complex input procedures

A further general problem is that in several countries some decision-makers are hesitant to transform the less-transparent input financing into results-based funding, which transmits money directly to providers and the population. The latter approach is more transparent and less likely to lead to corruption. The best way to remedy this is to offer performance contracts to the main actors and departments of the ministries of health and finance. This should enable them to obtain a competitive remuneration adequate to only defend the public interest instead of earning money through shady deals.

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Messages from Nigeria, Liberia, CAR and South Soudan

The 80th international PBF course organised by SINA health in Mombasa-Kenya in November 2019, welcomed 37 participants from Nigeria 19; Liberia 16; South Sudan 1; and CAR 1. Most were from the health sector. Hereby the detailed course report.

This course was evaluated by the participants as one of the best since 2007. The criteria methods and facilitation, participation and organisation scored very well with averages of respectively 95% 93%, and 94%. The final evaluation indicated that for 100% of the participants the content of the course related well to their professional activities and that the methodology of the course was excellent. Yet, 50% of the course participants also commented that the course was too short. Continue reading

The 80th PBF course in Cotonou with messages from 10 countries

The 39 participants to the PBF course in Cotonou

The 80th FBP course took place in Cotonou from June 17 to 29, 2019 with 39 participants with 10 countries represented. Hereby the detailed course report.


  • We report that in Burundi, Gabon, Mauritania, Ivory Coast, Cameroun, the Democratic Republic of Congo and the Central African Republic performance-based financing is advancing well.
  • Yet, delays of subsidy payments in Cameroon caused by factors not related to PBF has created serious problems.
  • There are prolonged delays in the scale up of PBF in Guinea Conakry and Madagascar and efforts to restart PBF in Benin have not yet been successful.
  • Yet, overall, when reviewing the results from these 10 countries, the balance is positive. Lessons learned are becoming available both from positive experiences but also from mistakes made.

The PBF course was successful in exchanging the above experiences and all the participants from in total 11 groups developed excellent action plans that are likely to advance PBF in the 10 countries represented. Continue reading

77th cours, financial procedures and emergency PBF

The 77th performance-based financing (PBF) course took place from Monday, May 13 to Saturday May 25, 2019.  Hereby the course report

                    The 51 participants of the 77th PBF course

The course welcomed a mixed group of 51 participants from the Ministry of Health, the Ministry of Finance, the National Civil Status Registration Office, the Ministry of Economy, Planning & Regional Development, and the Governors’ office of the West Region. All participants conducted the final exam. The overall score of the final test was 70% and eight participants obtained distinctions for their final exam with scores of 87% or more.

The status of PBF in Cameroon

By the end of 2019, 100% of the Cameroun population will be covered by performance-based financing and will be 10th low or middle income country to achieve this. 100% of the 2.7 million town of Douala is now under PBF with 80-90% of the contracts given to the private sector. Continue reading