ARTICLES EGPAF PRESENTATIONS

Do incentives matter when working for god? The impact of performance-based financing on  Effect of Family-Centered Model of HIV Care on Viral Suppression and Retention in Care of HIV-Positive
faith-based healthcare in Uganda Children in Eswatini (FAM-CARE Study)
The authors used panel data from faith-based healthcare facilities in Uganda to estimate the JOURNALS & WEBCASTS
effect of PBF. The output of the observed facilities is less than 50% of their potential and that Each title will link you to the original webcast. Notes on each webcast are below.
PBF increased output and allocative efficiency robustly by at least 27%. They did not observe Identification of Survivors of Intimate Partner Violence within HIV Clinical Settings
any apparent reduction in the perceived quality of services offered. They conclude that PBF
also works for faith-based facilities.
 Gender based violence is a barrier
Does payment for performance increase performance inequalities across health providers?
at each stage of the cascade, and
A case study of Tanzania
needs to be addressed to reach
Authors found that performance payouts were initially higher among higher-level facilities the 90*90*90 goals.
(hospitals and health centres) compared with dispensaries, among facilities with more  PEPFAR is closely aligned with
medical commodities and among facilities serving wealthier populations, but these
WHO minimum package for
inequalities declined over time. P4P had greater effects on coverage of institutional deliveries
victims of GBV
among facilities with low baseline performance, serving middle wealth populations and
located in rural areas.  PEPFAR indicator to track GBV
packages of care
Key Messages:
 Inequality in payouts favored better-off facilities, but declined over time.
 Lower baseline performers improved most on institutional deliveries coverage.
 Rural and middle wealth facilities improved most on deliveries coverage.
 Routine enquiry should only be
 Performance on antimalarial provision was similar across facilities. done when there are resources
Coming Full Circle: How Health Worker Motivation and Performance in Results-Based available to support women that
Financing Arrangements Hinges on Strong and Adaptive Health Systems - Zimbabwe disclose.
 Evidence suggest that women who
The study tries to understand why health workers working under the RBF arrangements in
experience violence do not always
Zimbabwe reported being satisfied with the improvements in working conditions and
compensation, but paradoxically reported lower motivation levels compared to those not share they are victims of violence.
working under RBF arrangements. Clinical setting is an opportunity to
connect survivors to resources to
Key Messages
support and help them.
 Importance of recognizing RBF as a policy intervention being introduced in a complex
environment with pre-existing dynamics. It is critical that those contemplating the
introduction or scale up of RBF arrangements, or for that matter any complex health
system reform, recognize that the process entails inserting complex
relational dynamics within the larger health system; many of which are potentially
 Integrating IPV into Clinical Settings
disruptive of the status quo.
 The implicit assumption that RBF-interventions will ‘automatically’ improve  Why do women not report?
leadership and teamwork to achieve motivation to perform better is not true. o Reliant for shelter, funds, status, victim shaming,
and/or fear they will not be believed and will not
 For effective implementation of RBF arrangements, explicit organizational change
receive services
management processes need to be put in place, across the health system.
 Minimum requirements needed to do routine enquiry for
violence
TOOLS o Quality screening can save lives but if done without
WHO - Violence against women: Strengthening the health system response services or poor services it can re-traumatize the
Animated video that provides statistics on violence against women, various effects of survivor
violence, and the role health centers can play in supporting survivors. o Privacy for enquiry of violence, and availability of
services, and criminal justice system to support them
PEPFAR - FY 2018 PEPFAR Sustainability Indices and Dashboards (SIDs) o Confidentiality – family’s should not have access to forms of survivors; and survivor should
The Sustainability Index and Dashboard (SID) is a tool completed periodically by the U.S. provide consent for referrals
President’s Emergency Plan for AIDS Relief (PEPFAR) teams and partner stakeholders to o Only talk about abuse when the survivor is alone; this includes children over the age of 2
sharpen the understanding of each country’s sustainability landscape and to assist PEPFAR
 ANC, Family Planning Counseling, HIV
and others in making informed HIV/AIDS investment decisions.
Testing & Counseling, and HIV Care and
Based on responses to 90 questions, the SID assesses the current state of sustainability of
national HIV/AIDS responses across 15 critical elements, with scores displayed on a color- treatment are appropriate settings for
coded dashboard. As the SID is completed over time, it will allow stakeholders to track routine clinical enquiry of violence in
progress and gaps across these key components of sustainability. Completion of the SID is LMIC
optional for countries within regional programs.  Do not persuade her to leave the
relationship but offer information on
services.
 Experience is that women do not disclose
when first asked but will come back even
years later when they are ready to seek
services
 Do not blame or pity her

Mozambique Experience with Clinical Enquiry of

Violence

 Pilot study to assess feasability and

acceptatilty of standard routine GBV Clinical
Enquiry (CE) in clinical settings
 GBV tool introduced in high HIV prevelance
 areas; in facilities that could provide minium package of GBV services and referrals, and providng
voluntary counseling and testing services, ANC and PMTCT, ART services
 Patients were happy with GBV CE tool, but only 40% felt free to speak about GBV due to stigma etc.
 Providers liked tool and increased patient information on services. The providers didn’t want to screen
because they also struggle with GBV. Majority also mentioned privacy and not work overload as a
barrier.