Direct Health Financing Yields Results in Senegal

The District Health Center in coastal Mbour, Senegal is a vibrant hub for health services, serving a growing coastal municipality and its outskirts. The center is constructing an x-ray facility, installing new dental equipment, and plans to upgrade its laboratory. The center is seeing more patients, has filled staff vacancies, increased staff salaries, and improved staff morale and performance.

The force behind these changes is a direct financing approach which provides financial support in addition to the government budget, according to terms spelled out in a contract between USAID and the regional and local health authorities. Health facilities receive quarterly payments against the achievement of an agreed-upon set of targets for delivery of eligible health services. The system was put in place in Mbour in 2012 with the help of USAID’s Senegal Health System Strengthening (HSS) program, led by Abt Global.

“Everyone is very supportive of direct financing. The staff are more motivated now,” said District Medical Director, Dr. Fatma Sarr. “They report for work on time, stay until closing, and there are fewer absences.”

“My job as a manager has changed,” Dr. Sarr said. “We used a part of our funding to install an electronic financial management system. Now I receive the daily payments data on my phone each day and manage invoicing very quickly, compared with the manual system we had before.”

The system has minimized undocumented transactions and financial mismanagement, resulting in higher revenues, which are being invested in improving service quality, staffing and infrastructure.

Now the District has funds to carry out the national Stratégie Avancée mobile outreach program. Funds from direct financing support transport for health workers to travel to remote communities lacking access to primary health care services.

“We are now one of eight districts nationally to achieve 80 percent full immunization rate and we are a leader in family planning coverage in Thiès Region,” Dr. Sarr said.

Read more about this work: 
Senegal HSS: Implementing Universal Health Coverage