The PBF Training in October 2012 was a Success!

The third and last round for PBF Training for Health Workers in Rungwe was officially closed on 4^th October 2012 by Zonal Chairperson of the CSSC- Southern Zone Rt. Rev. Bishop Dr. Israel- Peter Mwakyolile at Catholic Youth Centre in Tukuyu. The training took ten days from 24^th September to 4^th October 2012. A total of 14 PBF modules were covered.

The official closure had many colourful events: A word of thanks from 20 trainees from Health facilities in Rungwe- both Public and Faith Based. They thanked the Donor for sponsoring the training course and acknowledged the facilitators from KCMC and CSSC for imparting them with knowledge on PBF which will enable them bring change in the health facilities they work.

Thereafter, the PBF Training Coordinator Dr R. Manongi noted that, this has been the best class as compared to other three classes- 2010 and 2011. She said as trainers, which is something one can be proud of.  She promised that they will work on ways to have tailor made PBF Courses to different stakeholders in the Country beside incorporating PBF  in their curriculum.

The PBF Exams Coordinator Dr. Declare Mushi gave an overview of the average scores from the year 2010-2012. It is interesting to express that the average score increased from 59% in 2010, to 69% in 2011 and 72% in 2012. The improvement in the average score was attributed to many factors, but two were noted as determinants:  The use of Swahili in the facilitation plus the Swahili Manual for PBF increased the comprehension of the trainees on one part and on the other part, the facilitators gained experience on facilitating the PBF Training.  Therefore, it was apparent that language proficiency is one of the important determinants in the trainees understanding in training.

In his Speech, the Guest of Honor commended the trainees for the efforts they put in the course which resulted in such achievement.  He added that, at this point the important thing is the application of the PBF in improving the Health Care in our facilities.  He urged them to be change agents and improve performance in their health facilities.

He thanked the trainees from KCMC and PBF Pilot Project as Coordination office for CSSC for the good and hard work which is demonstrated by the average scores. He noted that the trained 60 staff located in various health facilities can act as a catalyst in bringing change in ways things are done. He shared efforts done by CSSC for bringing in board the decision/ policy makers as the High Level PBF Conference held in Dar-Es-salaam in March 2012 for the aim of making PBF as Health Financing Model. Additionally, he informed the participants that the Regional Health Management Team – in Mbeya are in favour of PBF as health financing Model as compared to traditional Health financing model. Finally, he awarded 20 trainees certificates of merits.

District Medical Officer Rungwe District Open PBF Training

District Medical Officer - Rungwe District Council opening PBF training for twenty (20) Health workers in Rungwe District on 25th September 2012. On his right side is Dr. Rachel Manongi- PBF Course Director from KCMC.

The third Round PBF training for Health Staff in Rungwe Opened by the DMO

This is the third and last round for PBF training for Rungwe District Health Staff. This year, the training involved 20 participants from: church health facilities, District Medical Officers Office, from Project and Church health Department.

It was officially opened by the District Medical Officer for Rungwe District Council on  25^th September 2012 at Catholic Youth Centre in Tukuyu, though the training started on 24^th September 2012. In his brief opening speech, the DMO acknowledged the financial support from EU and Cordaid for Rungwe PBF Pilot Project and for funding training for health Staff on PBF in Rungwe District. He argued the participants to take active role in the ten days training which will be culminated on 4^th October 2012. He emphasized that they are expected to be change agents in their health facilities through innovation and performance improvement in health Care delivery.

Additionally, he commended KCMC staff for their dedication to train health workers in Rungwe for three years consecutively. These precious efforts have resulted in having PBF pioneers who are resource persons for instituting changes in health sector.

Again, he openly noted that PBF is still needed in Rungwe District Council and Mbeya Region. The sixty (60) health staff trained to-date so-far by KCMC and CSSC will play a role of innovators in spearheading change in the health care. Thereafter, he shared the efforts of the District hospital in applying some PBF principles particularly in areas of: Vaccination coverage and Community Health Fund (CHF) promotion in the district.  He argued the participants to through understand PBF so that when they get back they become result oriented and hence make difference.

Moreover, he appreciated the efforts made by KCMC for translating training Manual in Swahili and for conducting the Course in Swahili as well.  Thus, Swahili being the National language will enable them to easily cope with the ongoing PBF training.

Below is the Group Photo- Guest of honour with participants after official opening.

Regional Health Management Team (RHMT) recommended PBF to enhance Performance in Health Sector.

On 28^th June 2012, Rungwe PBF Pilot Project Organized one day meeting for Regional Health Management Team (RHMT)- Mbeya Region and  City Council Management Team Members (CHMT)  at Regional Medical Officer (RMO) Conference room. It was part of Performance Based Financing (PBF) advocacy in the Region and we used the session as an opportunity to give feedback on the project implementation to the participants.

The meeting was officially opened by the Chairman of Christian Social Services Commission (CSSC) Southern Zone after some brief comments by Regional Medical Officer- Mbeya Region.

Thereafter, the Zonal PBF Coordinator made presentations, on PBF as Health Financing Model, and feedback of Rungwe PBF Pilot Project Implementation from 2010- June 2012. PBF) In a nutshell, the presentation contained: Basic Definition PBF, PBF inception in: Asia, Africa and Tanzania, PBF Multi- Country Network, Reasons for PBF to be Popular, Key Principles of Performance Based Financing (PBF), PBF Model on separation of functions. The other part was on Project inception, its objectives, expected output, stakeholders, main activities realized, challenges and achievement .

After the presentation, the participants discussed many issues; which included:

-          Strategies needed to make the decision makers understand the advantages of Output Based Financing against traditional model - input based financing,

-          Signing Service Agreement to lower Level health facilities modalities discussed

-          Delay in fund disbursement for Basket Fund to Health facilities in various Local Governments was briefly discussed. It was noted that part of the cause is delay of reporting as many councils have no specific officer to deal with that. Second, Budgetary sessions need to be amended, as presently the Budget session ends at the end of August, while financial year starts 1^st July.

-          Another issue raised was to reinstate the OPRAS (Open Performance Result Assessment) for her staff in order to increase performance in work place.  This was considered well aligned with Performance Based Financing. It was noted that there is need to have forums to advocated PBF from Lower level to higher level – Ministry, which was expressed as what the Project does.

As a way forward, the participants proposed the following:

-      The responsible authority i.e. Local Governments to work on modalities for lower Level Health Facilities to Sign Service Agreement in Rungwe District.

-      The Project in Collaboration with the financier see ways to incorporate the Regional Health Management team members to be trained on PBF

-      Disseminate PBF through various avenues in the Region such as Regional Health Committee which is the decision making organ.

-      Scale up PBF in Mbeya Region- all districts of Mbeya Region.  Regional Medical Officer indicated that the Region is ready to provide support needed for the scale up process.

From the general observation, it is obvious that the meeting was successful and it made the members enthusiastic, that with the available resources the health Care status in the region could be  improved provided that the financing model  is changed from input to output based financing. Below is the group photo of the participants after the meeting.

 

Council Health Service Board Meeting on PBF commended the Church leaders to mobilize their members for Community Health Fund

On 27^th June 2012 Rungwe PBF Pilot Project organized one day meeting for Council Health Service Board. The aim of the meeting was basically to orient the members on Performance Based Financing (PBF) as one of the health Financing model and secondly to update them on Rungwe PBF Pilot Project.

Moreover, It is worth noting that; Council Health Service Board is the highest Organ in the District responsible for all health matters.  Besides, they are the right people responsible for effecting change at District level on health.  

As a recap, the Zonal PBF Coordinator made a presentation divided into two main parts. The first part was on:  PBF as a Concept then expanded to Rungwe PBF Pilot Project- Project objectives; Project expected results, project stakeholders, and PBF Principles in general.

The second part was on the project implementation, what has been achieved so far, what were the challenges faced the project which so to say was a feedback.

These presentations led to very active discussions which were quite useful and as a response from the Board members. Mainly they are focused on these main issues.

The issue of maintaining quality of products/ medical supplies when you have many suppliers, how to move the decision makers so that they adopt PBF as one of the health financing model as other countries in the PBF network, the need for designing the PBF Project Proposal which will incorporate all the Health facilities in Rungwe District- as the Pilot focus more on the Faith Based Health Facilities.  Other important matters raised in the discussion were to mobilize the church Leaders to educate their church members to join Community Health Fund (CHF). Currently, only Government health facilities are responsible for treating Community Health Fund Members, a situation which several times have made the community members to demand establishing Government health facilities along the Faith Based Organization Health Facilities.

Generally, the meeting was a success in this sense. It enabled the board members to understand basic concepts regarding PBF and they appreciated Performance Based Financing (PBF) as the best model to solve many health issues facing the Local Governments and  one of which  is performance and staff motivation. Secondly, they have come up with ways to improve health facilities under the Faith Based Organization by sensitizing their members to join Community Health Fund and thus do away with out of pocket payment for accessing health Care.