Joseph ATTIAH, Program and Grants Liaison Officer , EGPAF-Côte d’Ivoire

Performance-Based Financing: A Mechanism to Improve Uptake of

Pediatric and Maternal HIV Care and Treatment

Joseph ATTIAH, Program and Grants Liaison Officer, EGPAF-Côte d’Ivoire

BACKGROUND

Established In Côte d’Ivoire since 2004, EGPAF focuses it’s support on C&T programs and PMTCT of HIV (project HEART)

By 2006, EGPAF initiated a strategic approach of partnership called PBF to enhance services provided on both quantitative and qualitative plans

PBF links the financial incentives to quantity and quality services provided to beneficiaries (PLWHIV and their families)

The present study was set out to examine uptake of indicators selected within the PMTCT cascade 137 supported sites including PBF and non-PBF sites were concern

METHODS

Retrospective comparative analysis of routinely data collected from January 2008 to June 2009Concerns indicators:

% of Pregnant women that received HIV counseling and testing % of Pregnant women who received their HIV test results % of Pregnant women LWHIV who received ARV prophylaxis % of children born to mothers LWHIV who received ARV prophylaxis in delivery

RESULTS

SERVICE % UPTAKE AT NON PBF SITES (N)

% UPTAKE AT PBF SITES (N)

DIFFERENCE IN UPTAKE

1. % of P. women that received HIV counseling and testing

86.2% (159,462) 90.3% (25,199) 4.1%

2. % of P. women who received their HIV test results

96.0% (153,006) 96.4% (24,709) 0.4%

3. % of P. women LWHIV who received ARV prophylaxis 72.9% (6026) 80.1% (1214) 7.2%

4. % of P. children born to mothers LWHIV who received ARV prophylaxis in delivery

55.9% (4452) 78.3% (967) 22.4%

LESSONS LEARNED

• PBF contributes to improving the quality of HIV-related services and the level of progress for indicators linked to the PMTCT cascade, in particular for maternal and pediatric care.

• In depth studies are planned in order to :– Provide further informations to improve the

approach – explain better the difference uptake observed

(explanatory factors) – Analyze and define how to expand this alternative of

health financing at the national level