We report on the PBF course, which took place in Douala from April 22 to May 4, 2019 with 58 participants from Cameroon. Hereby the detailed cours report (rapport du cours)
This time there was a large delegation of 13 people from the Ministry of Finance with 8 financial controllers and 5 Treasurers General of Payments (TPG) from 6 regions. There were 8 economic and social advisors of the governors from 8 regions. The Ministry of Planning and the Department of Civil Registration (BUNEC) were represented and there were two independent participants. All other participants were from the health sector
The daily evaluations of the course showed an average score of 80%, which is 1 point higher than the average of the 44 previous French courses. The impact of the 76th PBF course was reflected in the good quality of the action plans proposed by the different groups and the general recommendations (see the rest of this report).
Fifty-nine participants (including one participant from BUNEC, who assisted as an observer) did the post-test and the average progression from the pre-test was 29%. The average post-test score was 68%, which is 4% lower than the 72% average of the last 20 courses. Nine participants obtained a certificate of distinction with a score of 87% or higher for the final course test. Six participants obtained a certificate of participation with scores of 50% or less.
- Towards the end of 2018, performance-based financing in Cameroon covered 78% of the population and it will reach 100% during 2019 ;
- The liberalization of the pharmaceutical sector with the accreditation of pharmacies by the regulators has started to produce the results on improving the availability of medicines in certain regions such Littoral. This liberalization has also resulted in the increase of the health facility revenue rather than that these revenues benefit some monopolistic distributors. The health authorities in Littoral Region accredited 10 wholesale distributors in Douala and the other regions started the same accreditation process.
- The contracting of the regional and district health authorities produces good results. It better focuses the authorities towards achieving their core activities such as quality control and accreditation of the health facilities and pharmacies. This for most authorities is a welcome move away from wasting their time on the inefficiencies that existed in the old system of input procedures without a clear vision or objectives ;
As an example of the positive effects of PBF for the availability of qualified staff in remote areas, Ngong and Guider health districts in the Northern Region reported an increase in the number of qualified personnel by 98% from 55 to 109 between 2017 and 2019. PBF has a positive impact on the migration of qualified personnel to vulnerable PBF health facilities.
- Numerous PBF infrastructure improvements have been made as shown by the following images, pre- and post of Guider Health District in the Northern Region.