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What Are Results-Based Financing Programs Doing Around The World, State of The HRITF Portfolio

A presentation by Dinesh Nair, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014. This event was hosted by the Health Results Innovation Trust Fund at The World Bank, in partnership with the PBF Community of Practice in Africa.

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What Are Results-Based Financing Programs Doing Around The World, State of The HRITF Portfolio

  1. 1. Transforming Health Systems Through Results Based Financing Learning from Implementation & Impact Evaluations Dinesh Nair, Sr Health Specialist
  2. 2. Making an impact around the world
  3. 3. An expanding RBF Portfolio 79 160 121 177 175 36 projects 249 263 321 361 285 148 60 4 11 12 24 41 63 105 105 105 50 13 5 450 400 350 300 250 200 150 100 50 - FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20 Disbursements, US$ million IDA HRITF Note: Fiscal Year is July 1 through June 30. Projections for FY15-FY20 are based on total commitments and the expected closing date of the projects.
  4. 4. Early Evidence of Impact
  5. 5. Rwanda: Increasing Coverage and Quality 5
  6. 6. Improving Efficiency in Zambia & Zimbabwe 6
  7. 7. Using Operational Data
  8. 8. Operational data informs operations and learning • To monitor progress and assess RBF’s contributions to health system’s goals • To monitor what money is spent on • To identify areas for further inquiries and mid-course corrections • To assess the effects of RBF approaches • To facilitate cross-country learning and sharing of experience
  9. 9. The dashboards show real time performance and amount spent, down to the facility level.
  10. 10. Learning from Implementation
  11. 11. 1 2
  12. 12. Evaluating RBF Programs
  13. 13. Growth of the IE portfolio • 36 impact evaluations + 5 in pipeline • 5 program assessments including 3 completed • High increase in overall number = many at design stage • Impact evaluations also progressing to final stage • Endline surveys planned for 2014: Zambia, Zimbabwe
  14. 14. Diversity of Themes Intervention evaluated Countries Supply-side RBF payments Afghanistan, Argentina, Armenia, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Democratic Republic of Congo, Djibouti, Ethiopia, Gambia, Haiti, Kenya, Kyrgyz Republic, Lao PDR, Lesotho, Liberia, Nigeria, Pakistan, Rwanda, Senegal, Sierra Leone, Tajikistan, Turkey, Yemen, Zambia, Zimbabwe Demand-side RBF payments Gambia, Lao PDR, Nigeria, Pakistan, Rwanda, Senegal, Yemen, Zimbabwe Community-Based RBF Gambia, Haiti, India, Senegal, Rwanda RBF for quality of care Afghanistan, Argentina, Benin, Brazil, Cambodia, Cameroon, Central African Republic, China, Haiti, Kyrgyz Republic, Lao PDR, Nigeria, Senegal, Tajikistan, Turkey, Zambia, Zimbabwe RBF in hospitals Afghanistan, Argentina, Burundi, China, India, Kyrgyz Republic, Lao PDR, Liberia, Nigeria, Philippines, Senegal, Sierra Leone, Turkey Additional financing Benin, Nigeria, Zambia, Zimbabwe Differential incentive levels Central African Republic, China Enhanced monitoring and Cameroon, Kyrgyz Republic supervision RBF and training of providers Zimbabwe Process vs. output Brazil Negative Incentives (sanctions) Turkey 1 5
  15. 15. Innovations
  16. 16. Supply Chain
  17. 17. Quality of Care
  18. 18. Community & Demand Side RBF
  19. 19. Knowledge Sharing & Capacity Building
  20. 20. Scale Up
  21. 21. THANK YOU

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