Start: 2011
Phase: Pilot started in 2 districts – upscaled in 2015 to 80%
Coverage Estimate: 80%
Feasibility: 66%
Supported by: MOH/MOF, WB; Global Fund, Cordaid;

Description: 

The Ministry of Health and Child Care in Zimbabwe started piloting performance-based financing in 2011. The results of the impact evaluation in 2014 were encouraging and the Ministry adopted PBF nationwide financed by the World Bank and the Health Transition Fund (now Health Development Fund). Significant improvements in maternal mortality, child mortality, coverage indicators in ANC care and access to FP have been achieved during the last years to which PBF is likely to have contributed.

However, there are still design problems and the participants scored the pureness of the PBF intervention at 66% in the World Bank-financed and Cordaid supported districts and at 32% in the Health Development Fund-financed and Crown Agent supported districts.

Recommendations:

• Advocate for a purer form of PBF together with previous PBF course participants.
• Advocate that the Ministry of Health changes input budget lines from GOZ funding, levies, taxes, and partners towards PBF performance funding.
• Provide equal opportunity for obtaining PBF contracts to all health facilities whether public, religious or private; urban or rural.
• Enable a more competitive environment in the supply of health commodities by removing the restrictions that favor monopolies.
• Allow the Directorate of Pharmacy Services to work on accreditation of the public and private wholesale pharmaceutical companies including registration requirements and scope of work to allow entry into PBF.