History: A first pilot was proposed with the French Cooperation Agency in 2015. A PBF program started in 2019 with WB support.
Coverage Estimate: not sure
Feasibility: 24% for the pilot, not sure for a new program
Supported by: Ministry of Health, French Cooperation Agency, World Bank

Description: The Ministry of Health with the support of the French Cooperation Agency has expressed their willingness in 2015 to start a PBF programme in the Comores. Yet, the design was not pure according to the feasibility score of the SINA Health questionnaire, which showed a score of only 24%. Advocacy for a more pure design was therefore still required.

The government with financing from the World Bank has planned to start in 2019 a performance-based financing mechanism to ensure the quality of health and nutrition services through financing results, based on the quality of services produced by health facilities and district level. PBF will be used to finance activities contributing to the improvement of the quality of care as well as increasing services to be provided and to pay performance bonuses to the health personnel based on an indices tool.

Yet, this PBF approach is mixed with input components and only finances quality and not outputs.

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