District PBF Forum advised Local Government to respond to high health facilities utilization as a result of Service Agreement.

Rungwe District PBF forum serves as Public Private Partnership forum in Rungwe District. Its members are drawn from the Local Government leaders, the church leaders, the community representatives and the Health facility representatives. This time, the forum was held on 21^st June 2012 at Catholic Youth Centre with the objective of updating the members on the project implementation since they met last time in December 2011. A total of 13 people participated actively in the meeting.

The forum was opened by Chairman of Zonal Policy Forum Bishop Rev. Dr. Israel- Peter Mwakyolile.  In his opening speech he emphasised the need for coming together as partners. He elucidated the benefits of the dialogue between partners in the district, which resulted into signing of Service Agreement (SA) between two church hospitals and Local Government- Rungwe District Council.  Despite the challenges on the implementation of the Service agreement, the hospitals are providing services to the community.

He further expressed the very positive response from the target groups earmarked: the pregnant women and under five children to utilize the services.  On one side, it is quite good, that the service utilization is so much increasing, but on the other side, the health facilities are overwhelmed by such overflow from the targeted groups. So, that is an indicator which needs to be worked on by the Government to improve health care.

  

He reminded the members to work hard and diligently to apply PBF in the health Sector, so that other people from other areas could come to learn application of Performance Based financing, which will be reflected by service Provision in the facilities within the District.

The Zonal PBF Coordinator made presentation on the Updates regarding the project. The update included feedback on International Conference on Performance Based Financing (PBF) in Dar-Es-salaam, from 6^th- 7^th March 2012, the objective of the meeting was explained, the participants profile, the output of the meeting and the statement read by ministers as commitment  for PBF in the respective countries. Other two meetings output were presented which included: Church Leaders Meeting, Local Government Leaders Meeting. The Later was held as part of advocacy for PBF in the District and really served the purpose.

However, the updates stirred participants to raise questions. But they focused on Government efforts in adopting PBF as health financing Model, critical assessment of service Agreement signed between two church hospitals and Local Government. The other matters raised was the sustainability of the forum which brought public and private together for open discussions on matters related to health in the district, again, the  issue of how the PBF elements are manifested  in Rungwe Districts health facilities. Over and above the question of community members establishing Government health facilities along the church health facilities was also raised,

The issues raised were responded accordingly as follow:

The project is engaged in various Advocacy meetings in the Zone, and the CSSC Head office is doing at National level. As an example the PBF National Conference held in Dar- Es-salaam in March 2012 was efforts of the organization with donors to bring policy makers accept PBF in the health Sector by learning from other countries in the network where PBF is a national Policy(Rwanda, Burundi).

On critical assessment of Service Agreement, the Project has planned the stakeholders meeting for the aim of evaluating the Service agreement between two hospitals and Local Government- Rungwe District Council for Improvement.

As a response to sustainability of District forum, the Local Government Authority will be advised to maintain the forum, and hopefully they will agree as the Public Private Partnership is one of the government strategies in Health Sector.

The active facility Governing Committees (FGCs) in the management of the health facilities can be taken as one element of how PBF works in the District especially to the earmarked facilities. However, the peculiarity of the Project was clearly expressed to the members- as fund for buying indicators is the key for project to implement PB.
Again, the church leaders were asked to mobilize their members for Community Health Fund (CHF) around the church health facilities they become collection centres. currently only public facilities are centres for Community Health Fund(CHF) 

After the discussions, the members came up these recommendations:

-      The Church Leaders write a letter to DMO- Rungwe for appreciation for staff secondment to Itete and Igogwe hospitals (12), which will emphasize the need for more health staff in the health facilities as the Service Agreement has motivated the community members for utilization of health services.

-      The Zonal PBF Coordinator Communicate with the CSSC Headquarter to know the results of the International Conference held in March 2012 in Dar-Es-salaam. Also, the reaction from Ministry Of Health and Social Welfare.

-      The Zonal PBF Coordinator Communicate with the District Executive Director for  Rungwe District so as to use the District PBF forum as Public Private Partnership forum in the District with some improvement.

-      The church Leaders Contact District Medical Officer (DMO) – Rungwe to intervene on the construction of the health facilities along Voluntary Agency Hospital/ facilities by mobilizing their members to be Community Health Fund (CHF ) members.
As we implement the Pilot project, we are realizing the need to incorporate other components in this case- Community Health Fund which can contribute towards Health Services utilization in the catchment areas.