SUMMARY
Our scientific work is entitled "HealthNet TPO intervention in
the area health of
Butembo.»
The health actors in low-income countries are paying
increasing attention to performance-based financing or funding based on the
results. This system aims to improve performance quality and quantity of care
delivery. Its purpose is to make essential health care of good quality,
accessible and with the participation of the community. With sensitization of
COSA, the system should increase the utilization of health services by patients
and health facilities in this case should increase their own revenues.
Our concern if the system initiated by HealthNet TPO PBF to
fund health, reduced the financial barrier to access to health care? In
addition, this system he increased the flow of FOSA supported to ensure its
post-project?
In response to this hypothetical concern, we have glimpsed the
PBF has reduced the financial barrier to access to health care and the PBF did
not increase the self-supported health facilities. To support our assumptions
it has been necessary to analyze the data in different health facilities
supported by intervention of PBF, PBF also for intervention after surgery tends
to see the funding mechanism based on the performance of FOSA. After field
surveys we had the results as if the system PBF has even reduced the financial
barrier to access to health care in the sense that the system has encouraged
people to go ill be treated in health facilities supported. Given that the PBF
has reduced billing for health care, patients are coming in large numbers in
health facilities and more than half managed to meet their bills. The monthly
average solvency ratio was 69.25% before surgery to 73.32% during the procedure
and then 76.59% after the intervention. After PBF health facilities increased
slightly billing which decrease the rate of use of curative services. This
prompted us to confirm our first hypothesis. But today the situation is
returned to the starting position, the financial barrier to access to health
care has returned. Some people prefer to buy the drugs to pharmacies rather
than going to the hospital.
In 2008 health facilities have achieved an average of $
26,995.5 own revenue per month in 2010 an average of $ 30,180 a month and then
in 2011, $ 31,275 per month. These revenues are achieved in 2011 through
increased billing, given the number of patients who fall is difficult to reach
this amount with the pricing of HealthNet TPO. With the number of
Ix
patients that could increase the flow could increase, but we are
seeing a situation contrary, too many insolvent, then decreases in patients
after the program.
This led us to confirm our second hypothesis and we concluded
that the PBF has not sufficiently increased the flow of FOSA supported to
ensure its post-project. Health facilities have lost their motivation because
the performance has declined, they had already had a spirit of dependence on
outside, which is not good.
Apart from the introduction and general conclusion, our work
consists of three chapters. The first dealt with the health sector in the DRC,
the second dealt with the sketch of the environment and the third study
presented data and interpret results.
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