RBF IMPLEMENTATION PROGRESS MOHCDGEC 7TH JUNE 2017

Objectives “To strengthen health system for universal health coverage” “by improving the availability, accessibility and quality of health services and their optimal utilization”,

Tanzania’s RBF model Focuses on PHC Quantity and Quality indicators which exist within HMIS Quantity earning is topped up by a Quality bonus Payment of incentives made after verification Implementation started in 2015 as a pilot in Kishapu DC Rolled out for Shinyanga region Jan 2016 Currently 5 Regions and all MSD zones are implementing RBF Three regions Kigoma, Geita and Kagera trained awaiting to start implementation in July 2017

RBF IMPLEMENTING REGIONS HFs implementing RBF Eligible HFs % Pwani 123 273 45 Shy 163 169 96 Mwanza 157 290 54 Tabora 145 298 49 Simiyu 58 101 57 Geita 68 118 Kigoma 102 265 38 Kagera 186 281 66 Total 1,002 1,795 56

ACHIEVEMENTS Waste disposal Placenta pit.

Health commodities store

Buildings

Simple basic bed side investigations Simple tests such as RBG, UPT,HB,MRDT,HIV1/2, Syphilis and urine for glucose matter a lot.

Labour/Post-natal

Child care indicators

Quality improvement for Dispensaries and Health Centers

Quality improvements for Hospitals

Supply chain indicators

Error rate trends – service data

Fund utilization rates (Disps & HCs)

Fund utilization rates (Hosp & HTMs)

Fund utilization rates (MSD)

LESSONS LEARNT Strengthen PPP Follow clients/ patients at community level Team work in report compilation Introduction of reinforcements Ensure active participation of accountable leaders e.g DED Active and continuous communication

Comprehensive Outreach services… Use all possible partners in the Council

VEO office at a very remote village, people never accessed health services since then.

Report compilation At critical moments HCW are occasionally tempted to cheat by adding more clients to HMIS

+ve reinforcement.

DED- A take-charge person!!!!! HF CUG Engaging the District Director to be part and parcel of implementation has a big impact

Cont….

WAY FORWARD All eligible HF to be enrolled in RBF Establish an equity bonus for marginalized HFs Conduct operational research for informing the program Continue providing technical support to CHMTs and HFs for better performance Collaborate with DP to mobilize financial resources for adding more regions to the program

Finally!! Smiling faces, bonuses and good working environment.