THE Ministry of Health, Wellness and Elderly Affairs launched its Performance Based Financing (PBF) Pilot Program on Thursday, moving the island one step closer to universal healthcare coverage.
The PBF programme will provide free screening and treatment services for people with diabetes and hypertension, and will improve access to healthcare, Dr. Shana Cyr-Philbert, Senior Medical Officer for non-communicable diseases in the Ministry, said.
The programme will be introduced in a phased approach with the pilot phase to be implemented in eight healthcare facilities.
“As early as the 2000’s, Saint Lucia started its journey towards the delivery of Universal Health Care. Put simply, Universal Health Care or UHC as it is commonly called, involves giving people access to a full range of health services which they need without them being affected significantly (financially),” Cyr-Philbert said.
“Around 2006 the drugs for diabetics became free in our public wellness centers and this was the beginning of our UHC journey. On June 1st this year we launched another part of UHC, phase one, and this involves the addition of free laboratory tests and ultrasounds for expectant mothers. Today we are moving even closer to improving access to quality health services and products through the launch of the Performance Based Financing Pilot Programme,” she added.
Noting the severity of non-communicable diseases (NCDs), Cyr-Philbert said locally NCDs contribute to “most of our deaths every year and unfortunately high blood pressure or hypertension affects almost 40% of Saint Lucians.”
The PBF programme, however, can curb NCDs, she noted, and can even prevent deaths.
According to Cyr-Philbert, the provision of free medicines and lab tests “for all our diabetics and hypertensives within the PBF pilot regions will undoubtedly improve access to the care that is needed and it will prevent further heart attacks and strokes and even deaths… so PBF is us moving in a very positive direction.”
The Project Implementation Unit (PIU) has been working on the Performance Based Financing Programme over the past two years, Jeanette Hughes, Project Coordinator in the Project Implementation Unit (PIU) said.
According to her, a list of indicators has been identified to measure its performance.
“The health system strengthening project is one of two World Bank’s financed projects implemented by the Project Implementation Unit to support the Ministry of Health, Wellness and Elderly Affairs to reform the health services and to improve the delivery of health care within various public health departments and units,” she said.
“Component 2.1 of the project is called improving service delivery through performance-based financing… the main aim is to improve the efficiency of health expenditure by providing bonuses to service providers at targeted wellness centers based on performance,” she added.
Dennery Hospital, Soufriere Hospital, Richfond Wellness Centre, Desruisseaux Wellness Centre, Mon Repos Wellness Center, La Fargue Wellness Center, Jacmel Wellness Centre and La Croix Maingot Wellness Center will all be a part of the pilot phase.
Said Hughes: “The main deliverable for us is to develop a PBF scheme which will strengthen NCD management at the primary health care level.”
“Over the past two and a half years the team at the PIU has been working assiduously to remodel and redesign the original concept of the PBF to meet the prerequisites of the pilot project. A dedicated team was assigned to work on establishing the institutional arrangements preparing the legal covenants and designing the PBF by researching and reviewing the lessons learnt from other jurisdictions where PBF has been introduced,” she added.
And though preparing the PBF participating facilities “for the introduction and operationalization of the PBF scheme within their respective facilities was time consuming,” it was “quite rewarding,” she said.
“The team has spared no effort in their hard work in preparing the eight pilot facilities for phase one and will work with the same fervor to bring the remaining nine facilities on board by January 1st 2024,” Hughes added.