HEALTH BASKET FUNDS USING PERFORMANCE MECHANISM APPROACH TOWARDS STRENGTHENING HEALTH SYSTEMS AND PRIMARY HEALTHCARE SERVICES

Transcription

1 HEALTH BASKET FUNDS USING PERFORMANCE MECHANISM APPROACH TOWARDS STRENGTHENING HEALTH SYSTEMS AND PRIMARY HEALTHCARE SERVICES

2 Presentation Layout Background Information New Financing Mechanism Basic reporting requirement Base indicators Performance indicators CONCLUSION AND WAY FORWARD

3 BACKGROUND Since 2000, HBF has focused on strengthening the Tanzanian health system by providing additional funding to central ministries and local authorities in support of achieving results under HSSP (II,III & IV) Health systems strengthening and supporting primary health care services has always been a focus of HBF More money is channelled to the LGA level responsible for delivering primary health care services

4 There has been a reduction over HSSP III period in terms of number of Basket Partners and volume of HBF funding 2010/11 11 partners 2013/14 onwards 7 partners Background HBF

5 Background. However, HBF still important for LGAs HBF remains a critical source of funds, particularly at LGA level in support of Primary Health Care- Do not diverge follow the plan CCHP Disbursement equals budget Flexible source for LGAs to plan and utilise

6 Background HBF will continue as a funding modality for HSSP IV ( ) HBF in this period will include performance component to incentivise higher outputs at implementation levels Hoped that this will encourage more DPs to join HBF hence increase the volume.

7 Performance Mechanism Split between Base and Performance tranches FY2015/16 all Base FY2016/17 onwards Base + Performance Performance based on review of selected indicators (largely aligned with HSSP IV) Third-party verification of (a sample of) reported indicator values to ensure accuracy Necessary to mitigate against incentive to falsify data

8 Basic reporting requirements Provide basic accountability and transparency for HBF funds Without these, no funds can be disbursed. CAG Audits of the Health Sector for the prior fiscal. MTEF of MoHSW and PMO-RALG (Health budget) Financial statement of the Holding A/C Cumulative Quarterly Basket Finance Report

9 Base tranche: intent Introduce an element of performance but are designed to be achievable and build on improvements that have been achieved over HSSP III Disbursement on all or nothing basis ie if any are not achieved, none of the Base Tranche monies will be disbursed

10 Base tranche: Indicators % of council whose annual CCHP passes the first round of assessment %of completion of Star rating" assessment of PHC facilities % of annual employment permits for PHC staff given to the 9 critical regions Action Plans of Audits of PMORALG and MOHSW % of PHC facilities with bank accounts opened according to guidelines from MoF

11 Performance tranche: intent Intended to encourage real performance improvements in the sector Linked to the base indicators Disbursed on a sliding scale according to level of performance achieved.

12 Performance tranche: LGA indicators % of pregnant women attending four or more antenatal care visits (ANC4) Proportion of mothers who received 2 doses of intermittent preventive treatment (IPT2) for malaria during last pregnancy % of institutional deliveries % of women of reproductive age (15-49 years) using modern family planning methods Proportion of children months receiving at least one dose of Vitamin A supplementation during the past year Percent of PHC facilities with 3 stars rating or higher

13 Performance tranche: LGA Indicators 2 Number and % of Public primary health facility with at least one skilled staff % of PHC facilities with continuous availability of 10 tracer medicines (medicines, vaccines, medical devices) in the past year % of LGAs with functional CHSB (meeting quarterly) % of completeness of quarterly DHIS 2 entry by LGA (MTUHA phase one forms by Day 30 after the end of each quarter) % of LGAs with unqualified opinion in the external audit report

14 Performance tranche: Regional indicators RHMT s required biannual data quality audits (DQA) for LGAs that meets national DQA standards (1.Annual review of HMIS using standardized DQA tools 2. Annual verification field visit to spot check a random sample of 10% LGA, and 10% of facilities in each chosen LGA). % of LGAs submitting requests for CHF matching funds RHMTs required annual supportive supervision visits for LGAs that meets national supervision standards

15 Performance tranche: Central (MOHSW and PMORALG) Average and variance of LGA performance scores Average of regional performance scores % of unsupported expenditures in MOHSW/PMO- RALG in their annual audits Percentage of LGAs receiving CHF matching funds

16 Conclusion HBF remains critical source of funds particularly at LGA level in support of Primary Health Care Funds will not only be disbursed basing on need and demand but also performance. Continue working towards achieving the desired targets for the betterment of all Tanzanians. Accountable and responsible for the results

17 Way forward -HBF - MOU Implementation of this new HBF mechanism is guided by a signed MOU between the GoT and HBF DPs. Meeting all the conditions within the MOU More contributors more funding meeting our targets set within the HSSP4 MOU with all annexes will be forwarded to you Performance scorecards: Basic reporting requirement, Basic indicators, Performance indicators

18 Ahsanteni