Participants 40st PBF course in Benin
Hereby the report (Rapport Cours PBF Cotonou V241014) of the 40th PBF course that ended saturday the 18th of October in the Atlantic Beach Hotel in Cotonou. There were 34 participants (22 from Benin, 11 from Mali and 1 from Burkina Faso) and 5 facilitators. All 34 participants passed the final exam and six participants obtained a distinction.
The Benin group identified the following problems: (1) Health centers do not have sufficient management autonomy; (2) There exists a monopolistic system of procurement and distribution of essential drugs for government health facilities; (3) Health facilities are not allowed to recruit additional health workers even with their own (PBF) resources; (4) There is an incomplete separation of functions at the level of health districts and departments; (5) The PBF Program Coordination Unit (UCP) ensures at the same time the payment of the subsidies and recruits the Community Based Organisations (CBO), while it would be better to decentralise the contracting role to the Contract Development and Verification (CDV) Agencies at department level ; (6) The Secretary-General signs all the contracts with providers and CBOs while decentralisation of this contracting function to the Departmental CDV Agencies would be desired.
Visit to health centre
Recommendations by the Benin participants: (1) Promote more competition among suppliers of essential drugs and equipment and establish an updated list of suppliers from where health facilities are allowed to buy their inputs, while ensuring the establishment of a quality assurance system; (2) Lift the ban on the recruitment of staff as part of the empowerment of health facilities; (3) Clarify the mandate and the institutional set up in the context of the separation of functions and good governance between the providers, the regulators, CDV agencies, payment agencies and organizations that strengthen the community voice at peripheral level.
Chef de village et Dr Catraye
The Mali group identified the following problems: (1) There is an inadequate budget for the PBF program of less than USD 3.00 per capita per year; (2) There is an insufficient number of output indicators; (3) There Is not yet a comprehensive national PBF strategy; (4) Government providers are still dependant on central procurement of medicines and inputs; (5) There is a weakness in the PBF Community program; (6) Contracts are signed by the health committee and not by the head of the health centres; (7) PBF equity indicators are not yet introduced; (8) Private sector providers are not involved.
Atlantic Ocean Beach Early morning
Recommendations by the Mali participants: (1) Increase the PBF budget to at least 3 dollars per capita per year; (2) Increase the number of quantity indicators to at least 20, and thereby assure that the basic and hospital packages are comprehensive; (3) Develop a national PBF strategy document; (4) Improve the autonomy of health facilities by allowing them to buy essential drugs and other inputs from approved suppliers operating in competition; (5) Develop the PBF community indicators; (6) Sign contracts between CDV Agencies and the direct health providers; (7) Include PBF equity indicators for vulnerable areas and individuals; (8) Involve private organisations in the implementation of the PBF through the mapping of private structures and (sub)contracts.
