Contractual Approaches for Improving Health Services Delivery

Democratic Republic of Congo (DRC) is one of the largest countries in Sub-Saharan Africa. With almost 60 million people, this low-income country has been facing unstable security conditions for more than 15 years. Civil strife, wars, thousands of internally displaced people along with an economically and politically weakened Government led to the discontinuation of salaries to civil servants for more than 10 years.

In this context, the Bank and the Congolese Government decided to implement a new large scale “Emergency Multisector Reconstruction and Rehabilitation Project” in 5 provinces in the Western DRC. Improving healthcare services was a primary objective of this project. In order to increase the accountability of the sector, a Performance Based Contracts (PBC) approach was commissioned to improve services in 67 health zones, covering about 8.9 million people. GPOBA’s Technical Assistance aimed at developing and tracking metrics to implement PBCs and assess their effectiveness.

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This Technical Assistance effort has enhanced the Ministry of Health’s capacity for monitoring and evaluating the effectiveness of Performance Based Contracts (PBCs)

GPOBA funds have helped the Government develop systems for rewarding performance in the provision of health services in terms of quality if service and output levels achieved.

The DRC Ministry of Health

Eva Jarawan [3]