Burundi: Questions on the Financial Sustainability of Performance-Based Financing and Free Health Care

This document focuses on the financial sustainability of the strategy linking performance-based financing (PBF) and free health care (FHC) implemented nationwide in Burundi since 2010. It examines the financial resources invested by the government and its technical and financial partners to establish whether government resources alone can guarantee the financial sustainability of PBF-FHC or whether other inputs are required. To do so, this article specifically explores the approaches recommended to address financial sustainability in the context of PBF-FHC, namely: (i) the reduction of PBF-FHC implementation costs; (ii) the mobilization of government and partners resources; (iii) regular payment of health facilities’ invoices; and (iv) the integration of PBF-FHC in the national health financing strategy, which seeks to increase efficiency by integrating different health financing mechanisms.