Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
Performance-based financing (PBF) is the transfer of funds to health facilities so they can provide a pre-agreed set of services according to appropriate standards of quality and administration. These initiatives have introduced a wide set of refor...
| Main Authors: | , , |
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| Format: | Working Paper |
| Language: | English |
| Published: |
World Bank, Washington, DC
2021
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/undefined/935821632462316181/Alignment-of-Performance-Based-Financing-in-Health-with-the-Government-Budget-A-Principle-Based-Approach http://hdl.handle.net/10986/36362 |
| Summary: | Performance-based financing (PBF) is the
transfer of funds to health facilities so they can provide a
pre-agreed set of services according to appropriate
standards of quality and administration. These initiatives
have introduced a wide set of reforms, including in provider
autonomy, access to financial services, flexibility on the
utilization of funds, a performance orientation on the
budget allocation, and rigorous verification protocols. This
tends to set PBF apart from the prevailing public financial
management (PFM) systems that often remain input-based and
thereby create a sustainability challenge. If the prevailing
PFM system remains in parallel to the PBF, countries are
likely to return to the legacy PFM system once PBF donor
resources dry up. This paper unpacks this problem. It
develops a conceptual framework about how to think about
aligning PBF principles with PFM structures; offers a set of
diagnostic questions for an assessment; and helps guide an
analyst through the process of developing a reform roadmap,
considering country context. The paper also proposes a
reform roadmap to be centered around the following four
facility financing pillars: (i) provider autonomy, (ii)
financial management capacity, (iii) output-oriented budget
provisions, and (iv) a unified payment system. As a
discussion paper, this work aims to solicit feedback on the
proposed approach from the PBF and PFM community. |
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