Objectives “To improve maternal and child health in Zimbabwe”. “by improving the availability, accessibility and quality of key reproductive and child health services and their optimal utilization”,

Project implementation Through the establishment of a results based financing fund, which is managed by a National Purchasing Agency (NPA)

Project implementation Results based financing introduces incentives which are aimed at aligning individual and organizational goals general health system goals. PushPull

Components Results based contracts with: 1. Provincial Management Teams 2. District Health Teams 3. Health centers, where the HCC, DHT and the purchaser 4. Training, continuous supervision and learning

Institutional setup

Indicators included Primary Care - Health Centers Maternal Services, for example: Curative care consultations OPD (new consultation) Antenatal care visits (4) Pregnant woman tested for HIV Delivery attended by skilled health worker in health institution High Risk Maternal cases referral out Postnatal care visit First and repeat visits for FP modern methods

Indicators Included Primary Care - Health Centers Child Services, for example Child < 1 year fully immunized Vitamin A given to a child 6 to 59 months Secondary level - Hospital Maternal Services Normal deliveries in district hospital Deliveries with complications (caesareans excluded) Caesareans performed Family planning: Tuba Ligations

Other Instruments Equity fund Verification by community organizations Benchmarking as learning tool NPA support to create plan to meet minimal requirements

Timeline and Design Process March 2011 Preparation Grant signed and project design process started Development of Project Implementation Manual ongoing Learning by doing approach through selection of two frontrunner districts Experience in frontrunner districts will be used to finalize the project design Scale up to initially 2 districts per province

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