In the beginning of 2014, the Ministry of Health and Sanitation (MoHS)of Sierra Leone asked Cordaid to verify the results of their national Performance-based Financing (PBF) programme. This report summarizes the results and provides recommendations for further strengthening the health system.
The verification found an overall positive effect of the programme on quality of care, health facility autonomy and health worker motivation. Differences between several sources of information (reports by facilities, the national health information system, internal verification and external verification) were found and further strengthening of the national health information systems seems crucial. However, the verification found no proof that health facilities are intentionally inflating their patient numbers. Other recommendations for the PBF programme include strengthening of financial management at all levels and better operationalization of the purchasing function. In addition, per capita spending and downward accountability was found to be low and need to be improved to further strengthen the health system.
Based on the findings of the report, Cordaid was asked by the MoHS to support further strengthening of the health system, which was heavily challenged by the Ebola crisis.