Ministry of Health lauds Result Based Financing strategy

PIC: Health expert Enabel Belgian Development Agency Karel Gyselinck talking to Sarah Byakika,the commissioner for planning at the Ministry of Health (right) during the World Health Seminar on Results Based financing at Hotel Africa on April 10, 2018 (Credit: Hajarah Nalwadda)

By Betty Amamukirori and Desire Amanya

HEALTH

KAMPALA - Districts in the West Nile and western region of Uganda are now reaping big from the Results Based Financing (RBF) strategy, which was implemented in the regions to reduce maternal and child mortality rates.

Speaking during the World Health Day seminar held at Hotel Africana on Tuesday, commissioner for planning at the health ministry, Dr Sarah Byakika, said there is an increase in the patient visit in the selected 32 government health facilities where RBF is being implemented.

She noted that the number of women choosing to give birth in the health facilities had doubled due to improvement in the quality of service delivery.

Byakika said the model has helped in the reduction of drug stock-outs since what is used is being properly accounted for because the health facilities are mandated to carryout quarterly assessments of the outputs.

RBF is a model used to give money to social programmes that work. In RBF, a payer or donor conditions payment to a service provider on desired outcomes.

It is designed to help people in poor countries live healthier lives by linking incentives to results.

Erwin De Wandel, the head of co-operation at the Belgian Embassy, said the model was introduced in Uganda in 2015 by a Belgian Development Agency Enabel, formerly called BTC.

He stated that the model had come at a better time when public health expenditure was decreasing, while the demand for health services was increasing amidst rapid population growth in the country.

Dr Christine Tashobya from the Makerere School of Public Health, explained that the model helps to empower people to demand better health services and motivates health workers.

She said it also introduces checks and balances, encourages better governance, improves the utilisation of under consumed service, especially among the needy and underserved population and supports development of robust health information systems.

Tashobya stated the in areas, where the system is being implemented, there is an increase in financial risk protection since funds are paid after verification of a particular performance.

Dr. Richard Mugahi, the district health officer Kabarole, said the model looks at the patient holistically, leaving him or her satisfied with the services. Kabarole is one of the districts with health facilities implementing the model.

He said the model had improved accountability on resources used and assessment of performance in the health facilities.

Hugo Verbist, the Belgian ambassador, noted that the system was a crucial tool in tackling the varied health challenges Uganda is facing such as the huge disease burden.

"I call on other donors to join hands so that we can pool funds in order to increase the efficiency of the model," he said.

The seminar was held under the theme, universal health coverage, everyone everywhere.  The model is aimed at helping Uganda achieve a Universal Health Coverage as envisaged in the Sustainable Development Goal 5.

Some Ugandans unresponsive
Byakika revealed that some of the health facilities refused to pick interest in the model due to the required self-assessment and viewed it as a strict tool. She called for attitude change.

On the achievement of universal health coverage, Dr Diana Atwiine, the health ministry permanent secretary, said universal health coverage is unachievable unless the country addresses issues of finance and limited human resource in the sector.

"Financing is one of the pillars we need to address if we are talk about achieving universal health coverage. We cannot achieve it until we get the desired money," she said.

She noted that issues such as accountability, quality healthcare and attitude change need to be addressed if the SDG goal is to be achieved.

"We have a huge disease burden, which needs to be addressed. We need to embrace prevention to help reduce overcrowding in health facilities and the financial burden of treating the diseases," Atwine stated.

Dr Jane Ruth Aceng, the health minister said the high fertility rate among the women in the country needs to be curbed such that the sector can have a manageable population.

"RBF is an important strategy in helping health systems but we need a concerted effort for it to work," she said.