Table 4 Design features of the PBF programmes across the three settings

Funder(s)

Dutch Embassy, Cordaid, other donors (varying over time)

Current PBF programmes:

• European Union / Fonds Bekou

• World Bank (PASS)

World Bank

Period of implementation

2005–2017 (with varying geographical coverage)

• 2015-ongoing

• 2016-ongoing

End of 2011 - ongoing

Who is included/ incentivised?

– Facilities (primary and secondary; public, private and faith-based)

– Zonal Health Management Teams (ZHMTs)

– Provincial authorities (later on)

– Facilities (primary and secondary; public, private and faith-based)

– District Health Management Teams (DHMTs)

– Regional and national health authorities

– [CHWs sub-contracted by health facilities for outreach activities]

– Facilities (primary and secondary; public and faith-based)

Indicators and services included (facility level)

Indicators and bonus attached varied over time depending on budget available and focus of donor(s). Overall, within the national basic package of services forprimary and secondary levels.

The service package is harmonised across PASS and Fonds Bekou programmes, and based on the national basic package

Basic package, including vaccination, assisted deliveries, consultations for under-5s, quality of care

Institutional arrangements:

- contracting

Agence d’Achat des Performances (AAP) for facilities and ZHMTs (Cordaid for provincial level)

• Fonds Bekou: Cordaid

• PASS: international implementing agencies (AEDES and Cordaid) for facilities + MoH’s Project Implementation Unit (PIU) for health regulation

Project Implementation Unit (PIU) within the State’s PHC Development Agency (SPHCDA), with international technical assistance from Oxford Policy Management (OPM) for the first two years before it started operating autonomously

- quantitative verification

AAP

• Fonds Bekou: Cordaid

• PASS: international implementing agencies (AEDES and Cordaid)

SPHCDA (initially with support from international TA)

- qualitative verification

ZHMTs/Provincial teams

DHMTs

SPHCDA (initially with support from international TA)

- community verification

Community Based Organisations, contracted by AAP

Community Based Organisations, contracted by implementing agencies

Grassroot NGOs/CSOs, contracted by the SPHCDA

- fund-holding and payment

AAP

• Fonds Bekou: Cordaid

• PASS: PIU with the exception of 10% of facilities which do not have bank accounts and therefore are paid via the implementing agencies.

SPHCDA

Fee exemptions for vulnerable populations

Initially not planned, but were later introduced [42]. Project’s evaluations noted that they were largely not functioning [41, 47]

• Yes for PASS project only (KII; [44]).

Introduced in Adamawa State only

Equity bonus across areas

No

• PASS: indigents are exempted from fee-paying, for which health facilities are compensated. Identification of indigents is done at community level without standardised criteria.

No