The 47 participants with the Minister of Health

The 74th International RBF course was held in Coyah in Guinea from the 10th to the 22nd of September 2018. There were 43 government participants from the central, regional and district levels, three representatives of partners organizations and one representative from the private sector.

The impact of the 74th RBF course has been reflected in the good quality of the group action plans (see rapport). The average pretest score was 32% and the post-test score was 62%  which means a 30% improvement. Three participants obtained a favorable mention for their final test with a score of 83% : Dr. Ahmed Sekou Tidiane BARRY of the Ministry of Health – DNESH ; Dr Moussa SOUMAH                                 of the Ministry of Health – SNAS and ; Dr. Houssainatou BAH from the District Health Directorate Dubreka. Continue reading →

The 33 participants of the PBF course in Cotonou

The 69th PBF course took place in Cotonou from 18 to 30 January 2018 with 33 participants from Djibouti (12x), Togo (11x), Mauretania (7x), CAR (2x), and Guinea Conakry (1).

The impact of the 69th PBF course has been translated into the good quality of the action plans produced by the country groups. The course facilitation team is experienced because they come from several countries (DRC, Benin, Burkina Faso, Netherlands) and also work in several countries. In addition, the CAR and Guinea Conakry delegations came with practical experiences on PBF from their countries. This helped other participants to better understand the realities and experiences of PBF around the world.

Five participants obtained a certificate of distinction with a score of 90% or higher for the end-of-training test. They were three from Mauretania, one from Togo and one from Guinea :

Summary of the recommendations of each country

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The 31 participants in Mombasa with the facilitation team

The 70^thperformance-based financing (PBF) course took place from Monday, May 28 to Friday, June 8, 2018, in Mombasa, Kenya. Thirty-one participants attended the course: 16 participants from Nigeria, 6 from Zambia, 5 from Ethiopia, 3 from The Gambia, and 1 from the USA.

Here is the detailed course report

The groups analyzed their health systems and produced detailed action plans on how to advance PBF in their respective countries, states, and regions. Thirty participants conducted the final exam and achieved an average score of 70%, including three distinctions.

Daily evaluations produced scores comparable to previous English spoken courses. The final evaluation indicated that participants felt the course content related well to their regular professional activities. Participants were also satisfied with the methodology and organization. Participants rated the course modules much higher than previous courses. Some participants commented that facilitators should acknowledge the importance of context-specific issues. The importance of respecting country-specific characteristics is fully recognized. At the same time, we value open, comparative debate in an international forum, which stimulates out-of-the-box thinking and is also a vital characteristic of the course.

The course was organized around a strong core of ‘developing individual and country action plans’. This conscious focus began a few years ago, and with each course, we give more attention to the action plans. We plan to advance this approach to the course, deepen the quality of individual or group action plans each time, and build the 17-course modules around this core task.

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The 32 participants with the authorities of Douala Town

The 71^stInternational PBF Course was held in Makepe Palace Hotel in Douala from 7 to 19 May 2018. Thirty-two participants attended the course with six facilitators and three dedicated staff at the Secretariat. Three participants were from the Central African Republic and twenty-nine from Cameroon. The average score of the 32 participants who took the final exam was 75% which is slightly higher than the previous test results of the PBF courses. Three participants were awarded the certificate of distinction.

Hereby the detailed course report rapport du cours.

Positive aspects of the course

The daily course evaluations by the participants were good. Also at the closing of the course, we received positive feedback from several participants on the content and methodology of the course.

The quality of the action plans was better compared to previous courses because there was more time for the participants to work on them supported by coaching by the facilitators during the late afternoons and evenings. In particular, the action plans of the Division of Cooperation (DCOOP), the General Inspectorate of Medical and Paramedical Services, the National Malaria Control Program, the Regional Funds for Health Promotion and the General Directorate of the Ministry of Health from the Central African Republic were of a high standard.

The Makepe Hotel was rated better by the participants compared to previous courses. The hotel has invested in improving the rooms and the conference center. Food services were considered satisfactorily.

Aspects of the course that require improvements

Turning Point Question

During the final evaluation of the course, 30% of participants said that “the objectives of the seminar were not related to their professional activities”. We did not really understand this feedback but it could be linked to the fact that some directorates and programs are not yet fully engaged in the PBF program.

The duration of the course was considered too short for 39% of the participants; which means that despite the extra Saturday it is still difficult to share the main elements of the course within 14 days.

There were printing errors in the course book whereby some lines at the bottom of the pages were not visible and some tables and figures were fussy.

General recommendations of the course participants to the Ministry of Health

• Restitution of the PBF course recommendations in the respective workplaces including in CAR (all participants);
• Start PBF contracts with the Directorates and Programmes, which are not yet enrolled (all participants)
• Introduce PBF in the course curriculum of medical training schools, nursing schools, ENAM, etc (all participants)
• Harmonize the tax laws for both public and private health facilities and create an equal playing field (DRFP with MINFI)
• Advocate with the Ministry for a more rational division of the health districts (DOSTS / DRSP / DMOs / CIS)
• Advocate that training schools select and train students to become health entrepreneurs capable of advancing PBF best practices and innovation (all participants)
• Integrate the PBF quality reviews and accreditation in the work of the Inspectorates of the Ministry of Health (IG with support PBF Unit)
• Disseminate the circular of October 2017 of the Ministers of Health and Finance circular on the financial management of health facilities in Cameroon and make sure the new procedures are implemented (IGSA / PBF Unit)
• Develop or update the current laws  and procedures of the Ministry of Health to support the PBF reforms (IGSA / DAJC / DCOOP)
• Review the community verification interviews by local NGOs and make sure that they abide by ethical standards such as confidentiality (PBF Unit, CDV Agencies, DOST)
• Put the municipalities under performance contracts to assist with the PBF community activities such as household visits (PBF Unit)
• Assure that there is sufficient funding for supplementary feeding indictors in the nutrition whereby health facilities buy the required inputs  (Directorate of Health Promotion)
• Add more information at the PBF / HMIS portal such as health facility revenues and number of qualified personnel (CDV Agencies, PBF Unit, CIS)
• Disseminate the national PBF manual towards all contracted structures (PBF Unit / Regional Directorates / DMOs)

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The 51 participants from the English-spoken PBF course

The 68th performance-based financing (PBF) course took place from Monday, March 5 to Saturday, March 17, 2018. Hereby the detailed course report.

The main objective of this course was to train in PBF all the remaining DMOs and Regional Delegation staff of the two English speaking North West and South West regions. This to assure that by the end of 2018 the scale-up of PBF in the two regions can be completed in all districts.

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