One of the primary purposes of Performance-Based Financing (PBF) is to contribute to the improvement of quality of care provided by health facilities. One of the strategies to achieve that goal is to integrate quality indicators in the payment formula of the health facilities.
Today, in a standard PBF program, the measurement tool used to evaluate quality is a comprehensive checklist that cover several topic areas. As a global priority, family planning is one of the topics included on the checklist, to a more or lesser extent, depending on the country. Since there is a financial incentive to meet the checklist requirements, it makes sense that facilities use the checklist to guide where they prioritize their attention and resources.
The problem is that there are a number of weaknesses consistently found in the way that family planning is measured within the current checklists. Fundamental indicators are missed, such as the availability of a contraceptive commodity as the condom or family planning educational materials. The use of composite indicators may blur an understanding of which services are provided. In addition, scoring systems do not provide an accurate picture of the state of family planning. For example, in one country it is possible for a facility to receive a score of over 90% in the family planning category even if there are stockouts of oral and injectable contraceptives.
A face-to-face event on Family Planning in PBF programs
This should be a matter of concern for all the actors involved in PBF programs. What’s the point of paying for quality indicators if they are not providing information to make necessary decisions about the program and creating real benefits for the population? In 2017, the PBF Community of Practice will tackle these issues and play an important role in contributing to the collective learning agenda on PBF and quality of care, starting with Family Planning.
This agenda will be an ambitious one. In the spirit of Communities of Practice, we want to make this a collaborative process from the start. We are putting together a working group to develop and implement the collective learning agenda.
The first responsibility of this group will be to co-organize, together with the WHO Department of Reproductive Health and Research, BlueSquare, and the Institute of Tropical Medicine in Antwerp a first face-to-face meeting. The main purpose of this event will be to bring together subject matter experts in family planning with PBF implementation experts. Together, they will re-think the current measurement tools and explore the feasibility of a research agenda.
By improving the effectiveness of the measurement tools, facilities will be guided and assessed by indicators that will help them to improve the availability, readiness, and quality of family planning services, and consequently, the family planning outcomes in their catchment area.
We are looking for experts in family planning and results based financing, at the global and local levels, to join the organizing committee. As a member, you will take part in changing the processes that affect the millions of women and their families that are being covered under the results-based financing programs.
If you are interested in applying to join the organizing committee, create your Collectivity profile and submit an application here. If you are unable to commit to the organizing committee, but are interested in participating in further activities of this learning agenda, stay tuned. There will be more opportunities in the future to get involved.