06 Nov 2013
The Lesotho Maternal and Newborn Health (MNH) Performance Based Financing (PBF) Project is a two phase operation that will be executed according to the provisions outlined in this Project Implementation Manual (PIM) which is supported by a detailed Project User Manual (PUM) and other Handbooks. Whereas the PIM provides a brief sector background, project objectives and components, and a roadmap of how the project phases will be implemented; what the institutional, organizational, implementation and management arrangements are; how the financial management and procurement arrangements will function; and the social and environmental aspects to keep in mind, the PUM (and handbooks) provides the individual details. The provisions of the PIM can only be changed by agreement between the Bank and the Government of Lesotho. The PIM provides a balance between wider guidance and a ‘set of operational details, instructions and guidelines in line with Ministry of Health/World Bank procurement and project financial management rules and regulations’.
The contents of this PIM are based on the project documents such the PAD, PUM, Health Policy and strategic plan, MOU between MOH and CHAL, MOU between MOH and Red Cross, including other research materials prepared by the Lesotho Project Team which is comprised of Government officials, donor partners’ technical staff, consultants and non-governmental actors. The health sector including its partners is all bound by the health policy and strategic plan and therefore the strategies outlined in this document will apply to all unless otherwise stated.
This document is comprised of eight chapters.
Chapter 1 provides a background to PBF and the Lesotho Health System thereby setting the stage for understanding why the PBF approach was adopted to address the challenges of maternal and newborn health among the Basotho. A simplistic model of the separation of functions and roles in the relationship between the purchaser, regulator and provider with the consumer in the middle is presented to demonstrate that the performance of all actors will be measured against the quality of services delivered and accessed by the mothers and newborns in selected districts in Lesotho. The decentralization process is also outlined.
Chapter 2 describes the project design, objectives, financing phases as well as the individual components.
Chapter 3 describes the institutional and implementation arrangement of the project. This is to ensure that the policy and authorizing environment, the management structure as well as the implementation mechanisms are in place and robust enough to deliver the project. The roles, functions and relationships of each level are articulated to ensure smooth delivery of services.
Chapter 4 details the contracts, determination of PBF benefits, performance payments, use of the PBF benefits, and business plans
Chapters 5, 6, 7 and 8 discuss the financial management arrangement, procurement arrangements, environment and social safeguards, and Monitoring and Evaluation arrangements respectively. Reference is made in Chapter 6 indicating that procurement arrangements are detailed in a separate procurement manual.