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Kigali, Rwanda│Tuesday, March 27, 2007

USAID is helping the Government of Rwanda (GOR) provide incentives for quality health care through “performance-based financing” (PBF), implemented by the USAID partner organization, Management Sciences Health (MSH).

The new PBF web site and database were launched at a ceremony presided by the Minister of Health, Dr. Jean Damascene Ntwawukuliryayo, and USAID/Rwanda Mission Director, Kevin J. Mullally, on March 27 at Centre Mamans Sportives in Kacyru. This launch coincided with the signing of 15 new contracts for HIV/AIDS services – 13 with health centers and two with district hospitals. The signing of these contracts is representative of the GOR’s expansion of financial incentives to improve the quality of health care service delivery, and the web site and database will help do that on a national scale.

Through the US President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. is implementing performance-based financing of health facilities that meet both the GOR’s targets for improved primary care, as well as PEPFAR standards for sustainable HIV/AIDS services. These services include HIV testing, prevention of mother-to-child-transmission of the virus, care and antiretroviral drug treatment (ART). Health facilities receive a portion of their PEPFAR funding for service delivery start-up (“input financing”), and then they receive the balance once they meet the targets set by the health facility’s own PBF committee (“output financing”). Through MSH, the U.S. is paying an average $10,000 per year for PBF at health centers, and $70,000-to-$100,000 per year per hospital. While there is a fixed fee per service, the health facility’s total payments are based on improved performance, with ceilings set for each facility.

To date, including today’s 15 contracts, 84 PBF contracts have been signed, and eventually US will support PBF for health facilities in all 22 of the country’s 30 districts where PEPFAR programs exist.

“Performance-based financing of HIV/AIDS services is a critical step in supporting the Government of Rwanda’s commitment to greater accessibility to higher quality health care,” Director Mullally said. “We have found that by providing financial incentives, especially when their use is determined by local stakeholders, health care improves in both efficiency, and most importantly, in quality.”

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