History: Pilot started in 2013 and scale up in 2015.
Coverage Estimate: 100%
Feasibility: Modest
Supported by: MOH; WB

Description: The pilot phase of the PBF program started in 2013 and by 2015 it was scaled up with a US$ 7 million grant to all public health facilities in Djibouti at the primary and secondary level.  Since 2013, the program improved health services to 171,222 beneficiaries in Djibouti-Ville, Ali-Sabieh, and Tadjoura. From 2015 onwards, the additional financing will allow the program to reach all of Djibouti, including the rural and remote areas of the country.

The Djibouti Improving Health Sector Performance Project is the first Performance Based Financing project in the Middle East and North Africa region.

Improvements are foreseen in the design of the PBF program and notably the separation of functions between regulation and contract development and verification, more autonomy for health facilities to purchase essential drugs and other inputs and the separation of health packages at primary level and hospital level.