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Shifting Gears: What Can Be Done To Mainstream PBF Into Government Budgets

Publication | pdf | 3.43 MB

Oct 26,2021

Performance based financing (PBF) has introduced significant changes to how providers are paid. With PBF the provider is established as its own budget holder and is reimbursed based on the level and quality of services that have already been delivered. This is a profound departure from an input-based budget system.

Despite its promise, there remains a sustainability challenge: as long as the PBF operates in parallel to PFM structures, it fragments the payment system and governments are likely to revert back to the input-based legacy PFM system after the project closes - even if the PBF approach has shown results. This note lays out the problem, and provides a basic logframe of how to engage for greater use of national public finance systems to support the sustainability of the reforms.