Recorded presentation

Charles Stover, MPA, Health Reform & Financing, Management Sciences for Health, 165 Allandale Rd, Boston, MA 02130, Rosendo R. Capul, Health Sector Reform Technical Assistance Project, Management Science for Health, Rm. 502, Ma. Natividad Bldg., 470 T.M. Kalaw St., Ermita, Manila, 1000, Philippines, Eddie G. Dorotan, MD, MPA, Local Health System Manager, Health Sector Reform Technical Assistance Project, Mangement Sciences for Health, Rm 502, Ma. Natividad Bldg, 470 TM Kalaw St. Ermita Manila 1000, Manila, Philippines, and Peter Cross, MA, Equity Project, Management Sciences for Health, 165 Allandale Rd, Boston, MA 02130, 617-942-9179, peterncross@compuserve.com.

Starting in October 2003, USAID initiated a radically new approach to providing technical support for family planning services in the Philippines. After 30 years of marginal success, USAID changed strategies toward direct engagement with local government units (LGUs) to improve services in cities and municipalities.

USAID awarded a 3 year contract to Management Sciences for Health to work directly with over 500 LGUs (covering at least 35% of the population), with the goal of increasing CPR by 5 percentage points (35-40). This approach is both a “health project implemented at the local level” as well as a “local government project focused on health.”

Performance-based contracting is used extensively as part of the project strategy at two levels. First, local organizations are contracted provide political and technical assistance to 30 local government units. Second, direct financial support is provided to selective LGUs through performance-based grants that are linked to achievement of specific agreed upon improvements in basic health services, improved systems, and steps toward sustainable financing.

During the first year of the project, 80 LGUs and 4 local organizations will be funded through performance grants and an additional 375 LGUs will be added in the second year. Strategies for this project are based upon previously proven experiences with decentralized management of family planning services and with integrated health sector reforms in 8 provinces and 50 municipalities. This approach demonstrates that performance based contracts with local governments combined with capacity strengthening can achieve important health results.

Learning Objectives:

• The experience shows how working directly with locally elected officials of cities and municipalities throughout the Philippines is achieving increased contraceptive use. These working agreements are supplemented by performance-based grants that are linked to improved performance in CPR, TB-DOTS case identification and cure rates, increased use of Vitamin A, and HIV/AIDS surveillance.

Keywords: Performance Measurement, Access and Services

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Management Sciences for Health

Recorded presentation