dff

The concept of Direct Facility financing in Malawi was developed by the Health Economics and policy Unit, and adopted by the Ministry of Health. Implementation of the DFF is done by the Ministry of Health and other partners including UNICEF. The goal of the DFF is “to increase access to, equity, quality of, and efficiency in the provision of health services through enhanced community ownership and oversight, direct facility funding as well as relevant PFM capacity building in order to improve health at the community, district and national levels”.

This goal is to be achieved through the following objectives

• To make available and gradually increase health financing at primary and secondary health provider level through Direct Facility Funding (DFF);
• To transform Health Facility Management Committees into Health Facility Boards (HFB) that provide robust public financial management oversight across the PFM cycle at facility level;
• To provide autonomy and capacitate health facility management and their teams across PFM functions of budget planning, execution and evaluation;
• To Institutionalize robust PFM institutional arrangements and capacity including a management information system for real time response, adaption and evaluation

With support from the Health Service Joint Fund, the HEPU has been tasked to evaluate the DFF. The HEPU therefore aims at monitoring a range of performance indicators: from inputs, outputs, outcomes and impacts, the performance measures of primary interest will be on service delivery outcomes. The HEPU is using impact evaluation (mixed quantitative and quality approaches) and cost-effectiveness analysis of the HFIG (to inform scalability) evaluation design, and inputs, process, effects (impact evaluation) and Costs (to facilitate cost-benefit analysis) data to conduct the evaluation.