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The Impact of PBF in Jimma Health System-The Story of Mustezam Jemal Ali

Story Health System Strengthening
Jimma -

Mustezam Jemal Ali, 24, has been working at the Seka Health Centre within the immunisation unit for about 18 months. Within her unit, she supports 5 health posts through outreach activities and administers routine vaccines to infants and young children. She also works closely with the Out-Patient Department (OPD) and the Maternal & Child Health (MCH) unit to ensure mothers and their children receive the required medical care, especially in emergency situations.

Mustezam recalled her experience working at the Seka Health Centre during the early days of the Performance Based Financing (PBF) project. She noted a marked difference between the way things were then, compared to how they are now. The health centre was frequently challenged by power outages. This would greatly disrupt their daily operations as there was no generator on standby to keep the power running. This was especially risky within the immunisation unit as the vaccines needed to be kept refrigerated at all times to maintain their potency and thereby effectiveness.

Mustezam Jemal Ali @Cordaid / Sena Alemu

When the electricity went off, we had to carry and transfer the vaccines to the Seka hospital or to a health post where there was power or a solar system to preserve the vaccines until the power came back. Moving vaccines around frequently had a damaging effect on their quality and our clients were forced to wait until the vaccines were returned to the health centre to receive service.” –  Mustezam

Mustezam further expressed that the overall service quality at the health centre was poor, and they did not have many clients visiting the health centre because of this.

Our motivation level was low, and we did not feel like we belonged. Despite our best efforts, clients were dissatisfied with the service that they received.”

– Mustezam Jemal Ali

A lot has changed at the Seka health centre since PBF according to Mustezam. For instance, their baseline quality score was around 50%; however, it has since increased to around 80%. She claims that the PBF intervention has positively influenced the quality of their record keeping, the quality of their service provision, and strengthened their discipline and readiness to come to work. Some of the PBF subsidies have been used to purchase diagnostic and other essential medical equipment that they previously lacked, as well as a standby generator. They have furthermore invested in the compound’s infrastructure through installation of ceramic tiles and a central water system. Clients have noticed the changes and are providing more positive feedback. Their service utilisation has since expanded, and they are serving more clients than ever before. 

PBF strengthens our work by filling so many gaps. Even though we did not lose any vaccines moving them here and there, keeping them with us is preferable. Now, we keep our vaccines safe with us. With the subsidies, we are improving the quality of our services and the working environment. Our compound is more appealing and cleaner than ever before. I am grateful to PBF and more inspired than ever before, and everyone is grateful to have such incredible support.”  –  Mustezam

Mustezam says that she would like PBF extended to other sectors, such as education and  scaled up throughout the country. She believes that it would be very beneficial to the country’s overall development.  

I have noticed a difference in my working habits and motivation to come to work. It has become a pleasant working environment. Me and my colleagues are learning from each other and the support from PBF is transforming me into the best version of myself. I am confident that PBF would positively impact all sectors of Ethiopia.” –  Mustezam