Countrywide implementation demonstrates that a national performance-based financing approach with both the public and private nonprofit health facilities is feasible in low-income countries.  Incentives reward both quantity and quality of curative, maternal and child health, and HIV/AIDS services.  Donor-funded pilots provided the evidence for the government of Rwanda to implement performance incentives as well as a menu of options that informed the design of a unified national model.



Guide de Formateur PBF, Pour le Modèle Centres de Santé, Rwanda, Février 2008.

En Francais / In French

Performance-Based Financing for Hospitals in Rwanda was tried out by the Rwandan PBF pilot projects during 2002-2005. Start of the pilots in 2002 was informed by experience from key actors in Cambodia, where contracting in and contracting out health services had been piloted by the Asian Development Bank, and various innovative methods were tried by NGOs to increase service production.

Based on early results, the Government of Rwanda (GOR) decided to incorporate Performance-Based Financing in the National Health Strategic Plan.

Le financement basé sur la performance fait partie intégrante du système national de santé. Il est appliqué dans les centres de santé et les hôpitaux à travers tout le pays ainsi qu’au niveau central du ministère de la santé. Les mécanismes du financement basé sur la performance sont en cours d’élaboration pour les mutuelles de santé, système national de santé communautaire et pour les comités des districts de lutte contre le SIDA. Un modèle national pour le financement basé sur la performance au niveau communautaire a donc été développé à l’issue d’un large processus collaboratif.

Performance-Based Financing is thoroughly embedded in the Rwandan Health System. It is practiced in health centers and district hospitals nationwide using common approaches. Ministry of Health Performance-Based Financing has started at the central ministerial level. Performance-Based Financing systems are being designed for the national Community Based Health Insurance system, and for the CDLS. A national model for Community Performance-Based Financing has been developed, using a broad consultative process.

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