Denis Porignon

Performance‐based financing for better quality of services in Rwandan health centres: 3‐year experience

In 2005, the Ministry of Health in Rwanda, with the support of the Belgian Technical Cooperation, launched a strategy of performance‐based financing (PBF) in a group of 74 health centres (HCs), covering 2‐m inhabitants. In 2006, PBF was extended to an additional group of 85 HCs, thus reaching 3.8‐m inhabitants. This study evaluates the effect of PBF on HC performance from 2005 to 2007. Composite indicators for measuring quantity and quality of services were developed and evaluated through monthly formative supervisions by qualified and well‐trained district supervisors. The strategy was based on a fixed fee per quality‐approved service. The entire budget spent on the implementation of PBF amounted to

How robust are district health systems? Coping with crisis and disasters in Rutshuru, Democratic Republic of Congo

0.25/cap/year, of which

Prognostic indices for mortality of hospitalized children in central Africa.

0.20/cap/year for subsidies and an estimated

Humanitarian Aid and Health Services in Eastern Kivu, Zaïre: Collaboration or Competition?

0.05/cap/year for administration, supervision and training. A positive effect on utilization rates was only seen for activities that were previously less well organized; in this case, growth monitoring services and institutional deliveries. The quality of services, defined as the compliance rate with national and international norms, rose considerably for all services in both groups. A sustained level of quality between 80% and 95% was reached within 18u2003months in the first group. A similar result was reached in the second group in 8u2003months.

The role of the Zairian Health Services in the Rwandan refugee crisis.

backgroundu2002Since the eighties, the North Kivu Province socio‐economic environment has been deteriorating. This province also faced an influx of Rwandan refugees in July 1994. The objective of the paper is to show how a rural health district has been able to adjust and maintain its medical activities under unfavourable conditions.