5 Insert the "Male Circumcision" indicator at the CPA level 01/01/2011 6 Adjust the definition of eutocic delivery and obstructed delivery recommended by WHO 01/01/2011 7 Enforce the reference system and cross reference between different levels of the health system: health care at a higher level should be conditioned by a letter of transfer signed by the lower level Advocate with political authorities and awareness in the community: note to the Minister of Public Health and fight against AIDS For the note : 01/12/2010 Proposed of implementation : 01/04/2011 * Problems with taking charge of free care support package for people with other coverage: MFP, Army, Police, Other Insurance Note to the Minister of Public Health and fight against AIDS For the note : 01/12/2010 Proposed implementation delay : 01/01/2011 PBF FINANCING 8 Change PBF budgeting for the period and present it to the CPSD In progress for 2010-2015 30 November 2010 9 Adopt strategies to bridge the financing gap: 9.1. Mobilising additional resources The mobilization has already started at the Government level (4 billion more expected in 2011), Global Fund against Malaria and Tuberculosis Continues 9.2. Reduce the price of some indicators in some provinces or across the Country This reduction started in the provinces that have exceeded budget estimates by more than 10% October 2010 9.3. Fund the free services only for emergencies and referrals Need for argumentation and advocacy with policy makers: Note to the Minister (see Recommendation 7)
Insufficient control mechanisms has perverse consequences: fraud, cheating, neglect of certain non-contracted services; Failure to pay bonus for performance in national hospitals due to structural problems of inadequate funding, with the resulting in low staff morale Recommendations The successful implementation of the PBF and in particular the achievement of health goals in general are undoubtedly subject to the capacity of the system, while leveraging the strengths, address weaknesses, deal with challenges, prevent threats and seize and exploit opportunities. It is recommended for managers and various stakeholders to undertake strategies and concrete and prompt action on: the mobilization of additional resources to fill the financing gap; streamlining the implementation of the policy of free health care; the implementation of a reference and counter reference system ; the installation of efficient internet equipment at central and intermediate levels; Recruitment of an expert in computer programming and a network administrator; strengthening the technical platforms of health facilities; Identification of areas of responsibility of all FOSAs of the country; Review of assessment tools for the implementation of the PBF; strengthening the monitoring and evaluation of the implementation of the PBF at all levels; the involvement of members of the extended CT-PBF in the monitoring and evaluation of the implementation of the PBF at all levels; accelerating the contracting process at the central level; the integration of strategies for financing the demand for care within the overall health funding system: community assurances and health insurance; establish mechanisms for effective integration of community-based interventions in the PBF.