MCD Inc.

Performance Based Financing

Project: Health System Support Project (PASS)

Location: Central African Republic

Duration: 2017-2018

Donor: The World Bank


MCDI acts as the External Evaluation Agency (EEA) for the Health System Support Project (PASS) in the Central African Republic (CAR) implemented by the Government of the CAR with funding from the World Bank. Under PASS, the Government of the CAR is introducing performance-based financing (PBF) in targeted regions to strengthen the delivery of health services.


PBF is an innovative, results-oriented approach to incentivize health providers based on their achievement of predetermined quantitative and qualitative performance targets. MCDI’s role as the EEA is to counter verify data prior to the payment of PBF incentives.


Counter verification is necessary to ensure the veracity of quantitative and qualitative data being claimed by the reference hospitals, health centers, health administrations at the health districts, Regional Health districts and structures at the central level of the Ministry of Health and Population and as reported by the Performance Purchasing Technical Assistance (PPTA) team which has been recruited and appointed by the PASS.


The EEA will identify structures, districts or regions that produce both excellent and poor results and analyze the causes of these outcomes. Operational research will be conducted on the successes and failures of the different strategies of health centers, health districts and the PPTA in order to inform future innovations.


Over the course of one year, quarterly reports will be published with results cross-checked against declared data, an analysis of the strengths and mistakes of the project, the performance of the PPTA and the central services, along with suggestions for improvement.


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