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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

National PBF scale-up in Cameroon – the 76th course

       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)

The 58 participants of the cours with national and regional authorities

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.

The achievements of PBF in Cameroon

  • 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 ;
  • A health centre in the North region before PBF rehabilitation

    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.

Continue reading

Ethiopia, Nigeria, Cameroon, CAR and the Netherlands? The 78th PBF course

Le résumé en français du rapport est présenté en bas

The next English-spoken PBF course will be in Mombasa ftom the 28th of October to the 9th of November, 2019.

This 78th performance-based financing (PBF) course took place from Monday, April 1st to Saturday, April 13th  2019, in Mombasa, Kenya. Twenty-six participants attended the course: 14 from Nigeria, 7 from Ethiopia, 2 from Cameroon and 2 from the Netherlands. 

Hereby the course report.

The Nigeria team consisted of fourteen participants, from the Ministries of Health in Adamawa, Borno, Kebbi, Kwara, Nasarawa, Ondo and Yobe States. The Ethiopia teams consisted of three participants from the Ministry of Health at federal level and four from a PBF pilot in Borona Zone in Oromia regionThe two participants from Cameroon were from the North West region. We welcomed one participant from CAR and two from The Netherlands – one working at CORDAID head office in The Hague, and the other a senior general practitioner in Holland.

The “Village 78” authorities consisted of the Village Chief, Dr. Omar IBRAHIM; the Deputy Village Chief, Flora KWIZERA; the time keeper, Buzinel Gudisa Mijena; the Finance Ministers, Kinyuy Margaret Gham and Kees Melcherts and the EnergizersBaba Laminu, Abubakar Abana and Mekdelawit Mengesha.

They actively supported the facilitation process and contributed to a congenial atmosphere while maintaining “order” in the village.

Evaluation of the course venue and the course

Twenty-six participants conducted the final exam. The average test score result was 67% with six certificates of distinction and six certificates of attendance.

This was the third course in the 4-star Traveller’s Hotel, which provided a professional and pleasant ambiance. This justified the higher full board tuition fee.

The daily evaluations yielded scores, which were with 85%, 1,6% above the previous 24 English courses and 6% above the previous French-spoken course. Methods and facilitation scored 87,5% (the same as the previous courses). Participation scored 87.2% (the same as the previous courses). Organization scored 86.6% (0,3% above the average of the previous courses). The subject of timekeeping scored 78,8% (6,2% above the average of the previous courses).

The final evaluation indicated that for 88% of the participants the content of the course related well to their regular professional activities. Yet, only 52% said that they were well-informed in advance about the course and some indicated that the course book should have been distributed 1-2 weeks in advance of the course. The fact that some participants’ names were only known a week before the commencement of the course contributed to this score. Participants were satisfied with the methodology and the organization. In October 2018 a large proportion of 43% of participants thought the course to be too short and nobody thought that the course was too long. This course we added one day (the Saturday) to the course duration and this worked better to reduce the time pressure to finalise the action plans as well as the course modules.


Central African Republic Security and Justice Sector Continue reading