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Driving teamwork and collaboration to achieve UHC: Results-Based Financing for Health in Zimbabwe

12th December 2019

District Medical Officer Dr Makonese assisting nurses with data collection at a rural health centre in Umzingwane District, Matebeleland, South Province, Zimbabwe.

Today is International Universal Health Coverage Day and to mark the occasion we’re publishing the latest edition of the quarterly publication produced by our Results-Based Financing for Health team in Zimbabwe. In this blog Team Leader Marie-Jeanne Offosse, shares insight into how effective teamworking and collaboration are transforming primary healthcare and contributing to global efforts to attain UHC.

Universal health coverage is defined as ensuring an entire population has access to needed quality health services without the risk of financial hardship. As we enter the decade of delivery for the 2030 Sustainable Development Goals, we are under pressure to redouble our efforts, since we still have some way to go to achieve this objective. WHO currently estimates that around 100 million people around the world are pushed into extreme poverty because of out-of-pocket spending on health, while 800 million spend at least 10% of their household budget on healthcare.

Reversing this trend is a major ambition for health reform in many countries, including Zimbabwe, and is critical for sustainable development and poverty reduction in any community.

The Results-Based Financing for Health programme (RBF) aims to address these issues and overcome barriers which are socially and economically determined by providing financial assistance to health facilities in rural areas. Twenty-five percent of a health facility’s subsidies are paid as staff incentives, on the condition that the facility as a whole scores above 60% for quality.

Structure, clinical and health facility management, planning as well as client satisfaction surveys are assessed collectively, to determine the quality of service output. This approach goes a long way in promoting UHC across rural areas and significantly improving the quality and quantity of primary healthcare delivered, which the WHO stipulates as the cornerstone for achieving UHC.

Teamwork and collaboration are central to effective and efficient health service delivery. The RBF programme issues incentives to increase the motivation of staff, which in turn contributes to clinical proficiency and improved citizen access at point of need. By establishing and implementing a system of incentives, the RBF programme encourages and capitalises on effective teamworking, since it increases each staff member’s willingness to collaborate and sense of accountability to other colleagues within the group. In order to meet the quality threshold of 60% and receive incentives, staff are aware that the standard of their collective performance must be high. This pushes each person to contribute and play their role in the improvement of service delivery.

Members of the community and staff at an RBF-supported rural health clinic work together to offload a delivery of essential medical supplies.

In the RBF approach emphasis is also placed on each individual’s qualities as this is key driver for effective teamwork. Each member of staff at the health facility will have unique knowledge and skills that contribute to service delivery. RBF creates opportunities to showcase and reward outstanding individual contributions by distributing incentives on this basis. This is calculated through number of hours worked, extra hours worked, and number of absences documented.

The result is everyone feels motivated and accountable for their performance within the health facility team, irrespective of their position. As they collaborate effectively and efficiently, the team can deliver greater quality health services to the communities they serve. If each facility accomplishes this, access to health improves, overcoming social determinants based on socio-economic status or geography, which previously served as barriers.

In sum, a community achieves UHC when primary healthcare facilities and systems are underpinned by a strong foundation created by each individual staff member contributing effectively to ensuring patients can access adequate and affordable services at point of need without falling into financial hardship as a result.

Download the latest RBF publication to learn more about how teamwork and collaboration across the programme is contributing to delivering UHC across Zimbabwe

Learn more about Crown Agents Results-Based Financing for Health programme in Zimbabwe.

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