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Major progress towards sustainability of Performance-Based Financing Health Programme in Ethiopia

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Jimma -

Health minister visits PBF facilities in the Jimma Zone  

Dr. Lia Tadesse speaking to other visitors.

Her Excellency Dr Lia Tadesse, Ethiopian Minister of Health, accompanied by His Excellency, Mr Henk Jan Bakker, the Ambassador of the Embassy of the Kingdom of the Netherlands (EKN), visited three health facilities implementing the Performance-Based Financing (PBF) approach on March 26. 

Cordaid began implementing the PBF health programme in Jimma Zone, Oromia Regional State, in 2019 following the success of the Borana pilot in 2015. Currently, the PBF interventions cover all health facilities, including 12 hospitals, 165 health centres and 737 health posts in the Jimma and Borana zones, and reaches approximately 4.3 million people.  

The minister of health, together with delegates from her ministry, the Embassy of the Kingdom of the Netherlands, and the Civil Service Commission, visited Sombo Health Centre, Seka Health Centre, and Seka General Hospital.  

It is impressive to see how PBF has helped the health facilities to improve their services in many aspects.”  

– Dr Lia 
Dr. Lia and others visiting Sombo Health center drug store. Photo from: @lia_tadesse

The purpose of the visit was to see the progress and improvements in the health facilities since the start of the intervention. PBF aims to strengthen health systems by improving access and the quality of services and data, while promoting transparency. It also improves the governance of health service delivery at woreda and zonal levels. 

During her tour of the health facilities, Dr Lia discussed with staff, clients and representatives from the Woreda Health Office and Zonal Health Department. “It is impressive to see how PBF has helped the health facilities to improve their services in many aspects”, the health minister says. “I have seen that they are using the PBF subsidies to incentivise staff, to improve the infrastructure and procure essential medical equipment, drugs, and supplies. This motivates the staff to give better care.”

Dr. Lia, Mr. Henk Jan Bakker and other visitors following presentation by Seka health center. Photo from: @lia_tadesse

Henk Jan Bakker, the Ambassador of the Embassy of the Kingdom of the Netherlands (EKN) also echoed the sentiments of Dr Lia: “PBF is a powerful driver of change and transformation in the health services of the country. It is also a driver that can be scaled up to get improvements in health care without necessarily driving up the cost to an unstainable level. PBF has done a lot in improving healthcare to the people of Ethiopia.”   

While many key stakeholders from the Ethiopian government, including the Ministry of Health and the Civil Service Commission, have visited PBF facilities before, Dr Lia’s visit marks a milestone towards the programme’s sustainability. The positive changes have piqued the interest of the ministry enough to further explore how PBF can be embedded into the Ethiopian health sector.  

The ministry is working on designing its own PBF pilot programme which will be tested in several other regions to determine its applicability and success potential, with the ultimate goal of determining the long-term viability in the Ethiopian context. With all the successes so far, Dr Lia is optimistic. “Sustainability is the key”, she says. “With the implementation of a wider pilot, we are going to see how the PBF approach fits into the government system. We do not want to start such a programme and then stop. We want to ensure that the approach is sustainable.”  

Dr. Lia and Health care staffs from Seka and Sombo Health centers. Photo from: @lia_tadesse

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