Starting date

Piloted in Armenia in late 2003 and discontinued in 2005. Relaunched in 2006 and nationwide implementation of RBF was achieved in 2011. The population is 2,9 million. The 2013-2019 budget WB support is $ 37 million.

Coverage

100%

Description

Results-based financing (RBF) has been integrated into the national health care financing system of Armenia covering all primary health care (PHC) facilities in the country. The RBF program contributed to a substantial increase in the utilization of PHC services and improved provider performance. There has been a successful scale-up and integration of RBF into Armenia’s primary health care system throughout the period 2000–2015.

Under the Disease Prevention and Control Project, the State Health Agency (SHA) of the Ministry of Health (MOH) of the Republic of Armenia purchases predefined MCH and NCD services from primary health facilities located in Yerevan and in the regions (i.e. Marzes).  Once these services have been verifiably delivered, PBF payments are disbursed on a semi-annual basis by the Health Project Implementation Unit (HPIU). These payments are typically used to motivate medical personnel, stimulate administrative staff, and support operational costs at the facility level.

At all levels, the implementation of PBF activities is regulated by the Ministry of Health which ensures compliance with PBF principles and objectives as well as alignment with national health promotion norms and guidelines at central, provincial and operational levels.

Armenia’s experience has important lessons for other countries and health systems at similar levels of economic development. Whereas most documented RBF programs focus on maternal, newborn, and child health Armenia’s RBF program also addresses noncommunicable diseases (NCDs). Moreover, Armenia’s case provides an example of an RBF program that has been largely supported through domestic funding.

Reference:

Health Systems & Reform  Volume 3, 2017 – Issue 2, Pages 117-128 (2017): National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia Varduhi Petrosyan, Dzovinar Melkom Melkomian, Akaki Zoidze & Zubin Cyrus Shroff