Performance-Based Financing Project

Photo by Sala Lewis

By focusing on productivity, results, and outputs—rather than just inputs to the health system—the Performance Based Financing project is increasing the use and quality of health services.

This project, funded by the World Bank through the Ministry of Public Health, took an innovative approach to improving health system services in two northern provinces through three major interventions.

The interventions included:

  • Performance-based payments to health facilities, which facilitate continual expansion and improvement of services
  • Development and support of mechanisms to manage performance-based financing at the provincial and district levels
  • Community surveys to assess the satisfaction of community beneficiaries with the quality of health services. 

By focusing on productivity, results, and outputs—rather than just inputs—to the health system, the project increased the use and quality of health services. The project illustrated that collaborative partnerships between payers and service-providing organizations can contribute to improving service delivery and quality and utilizing local health managers as important engines for innovation.

Pathfinder supported provincial health committees by recruiting and training the medical professionals to plan, budget, and monitor health activities, as well as to verify and validate data received from health centers and hospitals. Health centers and hospitals developed quarterly work plans with clear indicators and performance objectives and submitted them to provincial committees for validation. Results were shared at quarterly meetings, allowing high-performing facilities to share lessons and ideas with their counterparts.

The Ministry of Health, in recognition of Pathfinder’s good work on this project, approved Pathfinder’s proposal to continue implementing activities for an additional year in the two provinces. The third consecutive phase of this work focused on capacity building through activities such as coaching visits at health centers and developing a supervision tool for facilities and community actors.



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PAST PROJECT: From 2008-2014, this project developed family planning and gender-based violence services for emergency and transitional situations in Burundi and the Democratic Republic of Congo.


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