Health Center Performance-Based Contract

Many health centers are poorly staffed, lacking resources, and falling short in reaching their health targets. The people that suffer most from these gaps are the most rural and remote communities. Distance, poor or destroyed roads, and few transportation options mean that health center staff are unable to provide adequate outreach activities to the community. In order to improve health coverage, this program focuses on a strong collaboration between RACHA and Operational Health District (OD) to strengthen the performance of service providers at the health center level and encourage outreach activities by supporting contracts between supervising health authorities and health centers.

In order to assist health centers with transport issues, RACHA will provide two motorbikes to each contracted health center. The HCPBC is an effective approach to enhance the link between health centers and remote communities through strengthened outreach package of activities. The HC signs a contract with the Operational District to improve coverage of various indicators, such as vaccinations, pre-natal visits, and birth spacing counseling, by agreeing to monitor 18-21 performance indicators. RACHA conducts an initial assessment of status of indicators for comparison purposes, followed by assessments after one year and on the 16th month to monitor the progress or lack thereof of the key indicators in the community. Depending on progress, the HC may earn the right to continue to borrow the motorcycles or earn permanent use of the motorcycles. HCPBC is a motivational program for HCs to increase coverage, reach target indicators, and improve health services in all areas of coverage.