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...

Full description

Bibliographic Details
Main Authors: Piatti-Fuenfkirchen, Moritz, Hadley, Sierd, Mathivet, Benoit
Format: Working Paper
Language:English
Published: World Bank, Washington, DC 2021
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
id okr-10986-36362
recordtype oai_dc
spelling okr-10986-363622021-10-14T05:10:55Z Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach Piatti-Fuenfkirchen, Moritz Hadley, Sierd Mathivet, Benoit HEALTH FINANCING PERFORMANCE-BASED FINANCING PUBLIC FINANCIAL MANAGEMENT PERFOPRMANCE BUDGETING UNIFIED PAYMENT SYSTEM PROVIDER AUTONOMY REFORM PROCESS HEALTH FACILITY 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. 2021-10-13T16:05:29Z 2021-10-13T16:05:29Z 2021-08 Working Paper 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 English Health, Nutrition and Population Discussion Paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Working Paper
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
topic HEALTH FINANCING
PERFORMANCE-BASED FINANCING
PUBLIC FINANCIAL MANAGEMENT
PERFOPRMANCE BUDGETING
UNIFIED PAYMENT SYSTEM
PROVIDER AUTONOMY
REFORM PROCESS
HEALTH FACILITY
spellingShingle HEALTH FINANCING
PERFORMANCE-BASED FINANCING
PUBLIC FINANCIAL MANAGEMENT
PERFOPRMANCE BUDGETING
UNIFIED PAYMENT SYSTEM
PROVIDER AUTONOMY
REFORM PROCESS
HEALTH FACILITY
Piatti-Fuenfkirchen, Moritz
Hadley, Sierd
Mathivet, Benoit
Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
relation Health, Nutrition and Population Discussion Paper;
description 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.
format Working Paper
author Piatti-Fuenfkirchen, Moritz
Hadley, Sierd
Mathivet, Benoit
author_facet Piatti-Fuenfkirchen, Moritz
Hadley, Sierd
Mathivet, Benoit
author_sort Piatti-Fuenfkirchen, Moritz
title Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
title_short Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
title_full Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
title_fullStr Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
title_full_unstemmed Alignment of Performance-Based Financing in Health with the Government Budget : A Principle-Based Approach
title_sort alignment of performance-based financing in health with the government budget : a principle-based approach
publisher World Bank, Washington, DC
publishDate 2021
url 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
_version_ 1764485023766937600