An investigation into the effectiveness of performance based financing (PBF) in Non-governmental Organizations in Zimbabwe: A case of result based finance program for health in Marondera District 2011 to 2013

Abstract

Performance-Based Funding (PBF) has become increasingly popular in global health financing. PBF is defined as the transfer of resources for health on condition that measurable action will be taken to achieve predefined health system performance targets. Due to the apparent incentives that tailored resource transfers offer, PBF is increasingly promoted by leading global actors as a way to efficiently and effectively reform the way health systems are planned, financed, co-ordinated and steered, particularly in low- and middle-income countries. The concept of PBF started from the notion that even though resources are limited in low income countries, it must be possible to improve the effectiveness of the health sector by increasing the performance in terms of service quality, service utilization as well as improving staff motivation. World Bank is currently funding the implementation of a program called Results Based Financing (RBF) in Zimbabwe, through a NGO called CORDAID. There is limited systematic research evidence to confirm that PBF is (or is not) an effective strategy for reforming health system governance in a participatory, universally equitable and sustainable way as such, the researcher was prompted to study the concept. The main purpose of this study was to assess the effectiveness of PBF in non-governmental organizations in Zimbabwe using a case of Results Based Financing program for health implemented in Marondera district between the periods July 2011 to March 2013. The analysis from the empirical findings showed that PBF has improved health worker motivation, improved service quality and increased service utilization. The findings from this study were confirmed by findings from various studies done in other countries. The research was quantitative in nature and used self-administered questionnaires to collect primary data. Secondary data were also used to triangulate the findings from the primary sources. The main recommendation from the researcher is that donors in all the sectors of development should move away from the current “merit pay reward” system to a method that promotes challenges and accomplishments, by ensuring that recipients are paid for services after they have accomplished pre agreed targets. The researcher believed effective implementation of PBF will contribute to the reduction in donor dependency within the country and a quick recovery towards achievement of the Millennium Development Goals.