Sierra Leone

Start: 2011
Phase: Started a ‘PBF light’ program in April 2011 – new phase “PBF plus” in 2015 – revised PBF approach planned in two districts
Coverage Estimate: 100% primary level
Feasibility: Moderate
Supported by: MOH/MOF; USAID; WB


The PBF Light scheme 2011-2014 showed overall positive results until the outbreak of the Ebola Viral Disease, which impeded project implementation. Nevertheless, the EVD provided an important opportunity to refine the design of the PBF scheme and pilot it for five months in Bombali district. This new phase approach was known as “PBF Plus” and introduced a substantially larger financial envelope.  Given the high costs associated with this pilot, the Government opted out of this improved PBF model. It nevertheless used lessons learned to strengthen the implementation of the project. The Government is currently reviewing the experiences of “PBF Light” and “PBF Plus” and is designing a revised PBF model to be piloted in two districts starting in early 2018.

Considerable delays were experienced in disbursing PBF payments. These delays were mainly caused by inadequate funding, poor initial understanding of internal verification procedures, an inefficient vetting process at the MOHS, and limited capacity of local banks in paying a large number of health facilities. These delays were also caused by the EVD.  To at least halve these delays, the project focused on rationalizing the internal verification process, increasing both the frequency and timeliness of verification and regularizing engaging and coaching stakeholders, including local banks.   Additional attention was also given to strengthening management capacities to support the internal verification process.

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