Start: 2018
Phase: Pilot stage with $ 20 million for the period 2018-2023
Coverage Estimate: Pilot in two municipalities in two provinces
Feasibility: Low, according to standard PBF feasibility score
Supported by: MOH; WB

Description:

Health services indicators in Angola do not compare favorably to what could be expected with the annual per capita income of $ 3640. This is due to several technical, allocative and administrative inefficiencies. Moreover, the reduced oil price has impaired tax revenues and reduced government health expenditure. Out-of-Pocket health expenditure has more than doubled from $ 28,6 in 2012 to $ 65,2 in 2015 (World Bank database). The government agreed with the Bank in 2018 to provide a $ 110 million loan to improve the health services with a particular focus on quality.

Yet, the largest proportion of this loan is meant for input budget lines, while $ 20 million is reserved to pilot the PBF reforms at the provincial and municipality level. This is a positive development but the design according to the standard feasibility score assessment seems low.  Yet the project also foresees exchanges with other countries such as Cameroun, Zimbabwe, Nigeria, and Rwanda. These visits combined with key technicians attending International PBF courses could improve the design and thereby the chance of successful implementation.