Rwanda, led by its Ministry of Health,was the first African country to implement Performance-Based Financing (PBF) nationwide in its health centers andhospitals. The country then went on to pilot RBFinterventions at the community level. Rewarding communitymembers who provide and use Maternal and Child Health (MCH)services is an innovative form of Results-Based Financing(RBF). The supply-side of this community PBF scheme focuseson cooperatives of Community Health Workers (CHWs). It paysthem to provide selected MCH services and rewards them forthe quality of their reporting as well as for goodmanagement. Conversely, the demand-side of this communityPBF scheme provides women with in-kind incentives when theyutilize three selected MCH services in health centers.Verifying the performance of these interventions is anintegral part of RBF program implementation. This case studyaims to describe the verification mechanisms used in Rwanda,which include monthly verification of the quantity ofservices provided by the CHWs, quarterly assessment of thequality of the functioning of the CHW cooperatives(including its reporting), verification of the quantity ofin-kind incentives distributed in a less systematic way, aswell as counter-verification of these three verificationprocesses. This paper presents results of these verificationmethods, and discusses the obstacles faced, the way theywere addressed, and the challenges that are still ahead.This case study is part of a broader analysis, involvingmultiple country case examples. It endeavors to expandknowledge about verification processes and practices and toaddress the design and implementation needs of RBF programs.
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