Dinesh Nair, Sr Health Specialist
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Transcript of Dinesh Nair, Sr Health Specialist
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Transforming Health Systems Through Results Based Financing
Learning from Implementation & Impact Evaluations
Dinesh Nair, Sr Health Specialist
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Making an impact around the world
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An expanding RBF Portfolio
FY09 FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 FY20 -
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IDA HRITF
Disb
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ts, U
S$ m
illio
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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.
36 projects
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Early Evidence of Impact
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Rwanda: Increasing Coverage and Quality
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Improving Efficiency in Zambia &
Zimbabwe
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Using Operational Data
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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
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The dashboards show real time performance and amount spent, down to the facility level.
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Learning from Implementation
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Evaluating RBFPrograms
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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
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Diversity of ThemesIntervention 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, RwandaRBF 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, ChinaEnhanced monitoring and supervision
Cameroon, Kyrgyz Republic
RBF and training of providers ZimbabweProcess vs. output BrazilNegative Incentives (sanctions) Turkey
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Innovations
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Supply Chain
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Quality of Care
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Community & Demand Side RBF
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Knowledge Sharing & Capacity Building
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Scale Up
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THANK YOU