Results-Based Financing for Health (RBF) (Health Development Fund)

Project Overview

Project Title: Results-Based Financing for Health (RBF) (Health Development Fund)
Legal Entity: Crown Agents Zimbabwe (CAZim)
Project Location: 8 Provinces, 42 Districts (Zimbabwe)
Overall Project Value: USD $76 million
Number of Staff Provided: 40
Client: UNICEF
Funding Partners: DFID, EU, SIDA, Irish Aid, Gavi
Project Duration: 2014 – 2022

Project Background

The Results-Based Financing for Health (RBF) project aimed to support the Government of Zimbabwe in reducing maternal and child mortality while strengthening the country’s overall health system. The primary focus of the project was to improve key maternal, newborn, and child health (MNCH) indicators by incentivizing healthcare providers to deliver high-quality services.

By using the Results-Based Financing model, where payments are linked directly to the delivery of quality health services, the project empowered healthcare providers and institutions to improve their performance and outcomes.

Project Approach

Contracting Healthcare Facilities
Under the RBF model, CAZim worked closely with healthcare facilities to implement innovative strategies that increased access to and utilization of essential health services. These services included:

Reproductive, maternal, newborn, child, and adolescent health (RMNCAHN)
Non-communicable diseases (NCDs)
Tuberculosis (TB), HIV, and Malaria services

Strengthening Capacity
CAZim played a key role in strengthening the capacity of Provincial and District Health Executives. This ensured that they had the ability to effectively supervise rural health centers, improving the quality of primary health care services.
Service Delivery Verification
One of the key components of the RBF model was verifying the delivery of services. CAZim used both quantitative and qualitative data to ensure that healthcare providers were meeting the required standards for performance.
Continuous Evaluation
RBF is a dynamic model, and CAZim was committed to ongoing evaluation, identifying potential areas for improvement and adjusting the approach to maximize impact. The program also included engagement with Community-Based Organizations (CBOs) in 916 communities, conducting client satisfaction surveys that provided valuable feedback for continuous improvement.

Key Results and Achievements

1. Maternal Health Improvements

Facilitated 160,000 first antenatal care visits in 2019, marking a 180% increase from 2016.

2. Post-Natal Care

Achieved 5.5 million post-natal growth monitoring visits per year, supporting the health and development of newborns.

3. Maternity Waiting Homes

With RBF funding, 500 maternity-waiting homes were constructed across districts, contributing to a 50% decrease in maternal deaths during childbirth.

4. Healthcare Quality Improvements

Across all RBF health facilities, there was a 25% improvement in healthcare quality measures, reflecting significant progress in service delivery.

5. Data Accuracy Enhancement

The project resulted in a reduction in data error rates from 49% to 5% since the implementation of RBF, ensuring better tracking and reporting of health services.

Key Services Provided

Fund Management and Technical Assistance:
CAZim provided essential fund management services for the Zimbabwe Health Development Fund (HDF), supporting financial operations and ensuring that funds were used efficiently and transparently.
Performance-Based Financing:
As part of the RBF approach, funds were paid directly to healthcare providers based on performance, incentivizing higher quality service delivery in the health sector.
Health Systems Strengthening:
CAZim worked to strengthen Zimbabwe’s healthcare infrastructure, including improving health systems at the provincial and district levels, facilitating the smooth delivery of services across the country.

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