Research for stronger health systems during and after crisis

The Role of Performance Based Financing in health systems recovering from conflict – experience from Uganda

Wednesday, 25 Jun 2014

ReBUILD PI Associate Professor Freddie Ssengooba presented to the Ugandan National Workshop on Performance Based Financing (PBF) in April of this year. Professor Ssengooba highlighted the important role health systems play in social justice as well as delivering population welfare. PBF may not always promote the resilience of health systems in the longer term but many of the studies of PBF come from states emerging from conflict, where it is used to deliver a range of services through private providers.   

Professor Ssengooba argues that in low income countries like Uganda, the role of PBF may only be appropriate in circumstances where outcomes are easily measurable and doing so is not harmful to longer term health system development and achievement of social justice. Health financing models that are sustainable over time should be prioritised and perfected. A Cochrane Review published, February 2012 on Paying for performance to improve the delivery of health interventions in low- and middle-income countries - The Cochrane Library - Witter - Wiley Online Library suggests that far more research is needed on the effectiveness of performance-based funding, particularly as it is not a uniform intervention, but rather a range of approaches whose effectiveness is dependent on the interaction of several variables. This includes intervention design, technical support, and factors, such as the organisational context in which it is implemented. Watch Professor Ssengooba’s presentation here.