Publication: Verification of Performance in Results-Based Financing: The Case of Afghanistan
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2015-08
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2015-08
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Since the end of the Taliban period, Afghanistan made remarkable progress, particularly in the health sector. Between 1990 and 2013, infant mortality declined from 121.3 to 70.2 deaths per 1’000 live births; under 5 mortality diminished from 179.1 to 97.3 deaths per 1’000 live births; and maternal mortality dropped from 1’300 to 460 maternal deaths per 100’000 live births. To further improve the coverage and utilization of Maternal and Child Health (MCH) services, the Government of Afghanistan – under the stewardship of the Ministry of Public Health (MOPH) – launched a new supply-side Results-Based Financing (RBF) scheme, covering 11 provinces and providing a standardized basic package of health services (BPHS). This package focuses on priority MCH services such as antenatal care (ANC), post-natal care (PNC), delivery care, nutrition, immunization coverage, tuberculosis (TB), as well as quality of care. This RBF program contracts international NGOs, incentivizing them for both the quantity and the quality of select services.
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“World Bank Group. 2015. Verification of Performance in Results-Based Financing: The Case of Afghanistan. Health, Nutrition and Population Global
Practice Knowledge brief;. © World Bank. http://hdl.handle.net/10986/25125 License: CC BY 3.0 IGO.”
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Publication Verification of Performance in Results-Based Financing(World Bank, Washington, DC, 2015-08)The Ministry of Public Health in Afghanistan implements a supply-side results-based financing (RBF) scheme to improve the provision of a standardized basic package of health services (BPHS) to its population. Contracting NGOs and “contracting-in” MOPH providers, this RBF program concentrates on high-priority maternal and child health services in the BPHS such as antenatal care (ANC), post-natal care (PNC), delivery care, nutrition, immunization coverage, tuberculosis (TB), as well as quality of care. It includes an intensive data verification method, focusing on both the quantity and the quality of delivered services, which was implemented between 2010 and 2013 by international third party organizations. This verification method was specifically used to ensure that providers reach performance thresholds and disburse performance payments. This case study describes the major characteristics of this RBF verification method. Taking stock of the experience of the MOPH, it aims at generating possible lessons for other RBF initiatives, thereby expanding knowledge and making RBF verification processes more efficient, sustainable and effective. This case study also responds to concerns about the future sustainability of RBF, particularly with regard to the intensive and external nature of verificationPublication Verification of Performance in Results-Based Financing(World Bank, Washington, DC, 2015-08)This HNP knowledge brief focuses on the key findings of the World Bank case study entitled ‘verification of performance in Results-Based Financing (RBF): the case of Panama’s health protection for vulnerable populations program (PSPV)’ (2014). The case study covers 2011 and 2012 and concentrates its analysis on data stemming from two sources: quarterly reports produced during the verification process, and interviews conducted with stakeholders involved in the implementation of the PSPV program.Publication Verification of Performance in Results-Based Financing(World Bank, Washington, DC, 2015-08)Verification differentiates results-based financing (RBF) from other health-financing mechanisms, and it is considered an important process of RBF program design and implementation. Despite the vital role it plays in RBF, not much has been written about verification as a process, and information about different elements of the process, frequency, cost, and direct and indirect effects among others, is scarce. Panama’s Health Protection for Vulnerable Populations Program (PSPV) uses an RBF mechanism to deliver health services to the country’s rural poor. 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This case study aims to describe the verification mechanisms used in Rwanda, which include monthly verification of the quantity of services provided by the CHWs, quarterly assessment of the quality of the functioning of the CHW cooperatives (including its reporting), verification of the quantity of in-kind incentives distributed in a less systematic way, as well as counter-verification of these three verification processes. This paper presents results of these verification methods, and discusses the obstacles faced, the way they were addressed, and the challenges that are still ahead. This case study is part of a broader analysis, involving multiple country case examples. It endeavors to expand knowledge about verification processes and practices and to address the design and implementation needs of RBF programs.
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