Outcomes of a performance-based contracting strategy in south Sudan
Tuesday, November 5, 2013
: 3:15 p.m. - 3:30 p.m.
Background: The USAID-funded Sudan Health Transformation Project II (SHTP II) developed performance-based contracts (PBCs) with 9 sub-contracting partners (SCPs) in 14 counties to support rapid expansion of the basic package of health services (BPHS). Methodology: Through SHTP II a performance matrix was developed that linked key indicators of BPHS achievements by the SCPs to payments using a select group of 11 project indicators covering both program and management activities. Scores < 80% paid only 95% of the scheduled payment (a 5% penalty); 80-100% resulted in full payment; and > 100% generated a 6% performance bonus. Results: After implementing this payment formula, SHTP II demonstrated a rapid and significant increase in the provision of the key BPHS, eg, coverage of DPT 3 increased from 30% to 86% in just two years. ANC 1 visits increased 287% and ANC 4 716% and IPT 2 increased from 29% to 53% of PW during this time period. Conclusion: In the first Q of implementation, only 2 counties received a performance bonus compared with 7 (50%) in the last quarter. Tying payment to indicator performance improved access to BPHS services by incentivizing program acheivements and rewarding good performance. PBCs can play a strong role in rapid expansion of access to services even in a fragile, post-conflict state like South Sudan.
Administration, management, leadership
Provision of health care to the public
Identify the elements of a successful performance-based contracting strategy in community-based primary health care.
State the positive outcomes of the use of this technial approach in improving access to basic health services.
Keyword(s): Contracting, Primary Care
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I supervised the SHTP II which used performance-based contracting to rapidly improve access to basic health services in South Sudan.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.