Performance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number of impact evaluations have noted that PBF often produces mixed and heterogeneous effects. Still, little systematic effort has been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes.

Authors: Jean-Benoit Falisse; Petra Vergeer; Joy Gebre Medhin; Maud Juquois; Alphonse Akpamoli; Jake Robyn; Walters Shu; Michel Zabiti; Rifat Hasan; Bakary Jallow; Musa Loum; Cedric Ndizeye; Michel Muvudi; Baudouin Booto; Jean Claude Taptue Fotso; Severin Sokegbe; Ibrahim Magazi; Gil Shapiro

Performance-Based Financing (PBF) is a promising approach to improve health system performance in developing countries, but there are concerns that it may inadequately address inequalities in access to care. Incentives for reaching the poor may prove beneficial, but evidence remains limited. The authors of this article evaluated a system of targeting the poorest of society (‘indigents’) in a PBF programme in Cameroon, examining (under)coverage, leakage and perceived positive and negative effects.

This article describes the transition of responsibilities and functions from international non-governmental organizations (NGO’s) to national performance purchasing agencies during the Performance-Based Financing (PBF) program scale-up in Cameroon.

The Cameroon experience shares important lessons that may be helpful to PBF programs facing similar transitions in other countries.

Cet article décrit le transfert des responsabilités et des fonctions des Organisations Non Gouvernementales (ONG) internationals aux Agences d’Achat des Performances nationales.

L’experience du Cameroun partage des leçons importantes qui peuvent aider d’autres programmes PBF qui font face à des transitrions similaires.

Cette etude du Cameroun examine comment le Financement Basé sur la performance (FBP), entant qu’une approche de contractualisation peut renforcer le partenariat public privé,  améliorer les objectifs publics, et contribuer aux buts de la Couverture Sanitaire universelle.

This study in Cameroon examines how Performance-Based Financing (PBF), as a contracting approach, can reinforce private-public partnerships, enhance public health goals, and contribute to the goal of Universal Health Coverage.

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