Description of Session
Nigeria has been implementing Performance-based financing (PBF) projects to improve the quality of healthcare for many years now. As the managers of this program we will share our perspective on the project’s evolution from its beginning. We will begin with a description of why our government decided to take this route, we will share our experiences with different platforms and funding initiatives over the years, and the many challenges and lessons we have had to learn along the way. Implemented by the National Primary Healthcare Development Agency, Nigeria’s PBF system utilizes a suite of tools to incentivize improved healthcare provision. Our system depends on high quality data collected from facilities, verification of this data across different sources, and payments associated with results. The data flow in a PBF system begins with initially reported data (“claimed”), compared with “verified” data, and based on a complex series of algorithms, facility payments are adjusted based on either a carrot (bonuses if discrepancies are below a specified threshold), or a stick (sanctions levied if discrepancies are above a specified threshold). In recent years, the system has evolved from a stand alone platform to one centered around a DHIS2 instance. With the transition to a DHIS2-based system, the PBF platform is integrating with Nigeria’s national HMIS to ensure that data collection, analysis, and data quality efforts are efficiently used across the health system. This shift represents more than just increased efficiency, but an actual paradigm shift; instead of looking at different reporting streams or databases as project- or task-based, this is a change to true systems thinking. . This presentation is part of a panel that will be moderated by a counterpart from the Nigerian HMIS team who will provide a complementary stakeholder’s perspective.
