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Performance-based financing in Jimma

Project Health System Strengthening
Jimma -

Jimma Zone is an area with a low use of healthcare services, mainly due to long distances to the nearest health centre or hospital and the inability to meet transportation and treatment costs. This, combined with a low quality of health care and limited access to services, had adverse effects on improving health care and limited progress on maternal mortality reduction and postnatal care.  

Performance-based financing in health care

Performance-based financing (PBF) transforms the financing of health systems. The financing mechanism replaces passive purchasing arrangements by linking payments directly to performance. In PBF, healthcare providers receive payments after verification of their outputs. 

Cordaid Ethiopia implemented the PBF approach in Borana. Due to the results in Borona, we decided to scale up PBG in health care in Jimma. Since its implementation, the approach has substantially improved the access to health care, the quality of care and enhanced the reliability of data.

Jimma/ Oromia Region
Government of the Netherlands – Ministry of Foreign Affairs
Thematic area
Health care
Project period
4/1/2019 – 3/31/2023
Sustainable Development Goals
Good health and well-being

Project objectives

1. Improved health service delivery, which can be reflected in increased utilisation of good quality services and increased equity in access to those services.
2. Improved governance of health service delivery through increased capacity at the level of woreda health offices and zonal health department to perform their regulatory tasks and provide supportive supervision and institutionalisation of PBF in the Ethiopian health system.
3. An enhanced health information system that supports data-based decision making at woreda, zonal and regional levels and additional financing potential for the health system through enhanced transparency.

Photo: Petterik Wiggers

Target beneficiaries

Through 121 health centres and 7 hospitals, PBF targets over 3.5 million people in Jimma.


In Jimma, the introduction of PBF has contributed to an increase in the use of essential healthcare services, the quality of care, the satisfaction of patients and the reliability of HMIS data.

According to our verified data, the amount of women from the zone going to a hospitals or health centre to deliver their baby with professional care increased significantly: from 1% to 96% between September 2019 and June 2021. In addition, women who attended the first antenatal care visit before 16 weeks of pregnancy also showed an incredible increase over the same period, from 0.1% to 96%.

Visit Omo Nada Hospital in Jimma:

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