Table 1.

Comparison table between RBF and DHFF-HBF in Tanzania.

Scheme attributes	RBF	DHFF-HBF
Funders	World Bank & USAID	Development partners through a health basket pool of funds to strengthening health system
Piloting & early initiations	Pay-for-performance (P4P) pilot in Pwani region (2011–2014), followed by RBF pilot in Shinyanga region (2015)	The government and HBF partners signed MoU of adopting DHFF in 2015. Actual DHFF implementation started in December 2017
Facilitator (makes follow ups during the programme)	President’s Office, Regional Administration and Local Government (PO-RALG)	President’s Office, Regional Administration and Local Government (PO-RALG)
Regulator	Ministry of Health (MOH)	Ministry of Health (MOH)
Purchaser	National Health Insurance Fund (NHIF)	Ministry of Finance (MOF)
Fund holder	Ministry of Finance and Planning (MOF)	Ministry of Finance (MOF)
Verifiers	Internal verifier-Internal Auditor General (IAG) and a team identified by RAS (quarterly). External verifier -Controller Auditor General (annually)	No explicit verifier, but undertakes general annual audits across sectors including health by the Controller & Auditor General
Scale of implementation	9 regions (Mwanza, Pwani, Shinyanga, Geita, Kigoma, Kagera, Mara, Simiyu and Tabora)	All 26 regions in mainland Tanzania
Who received incentives/payment	Health workers and facilities, community health workers, health managers (CHMT and RHMT), and zonal MSD offices	All public health facilities in mainland Tanzania. Facility spending guide directs how funds should be used. There is 10% earmarked for staff motivation
Procedures in place to support facilities	Active Facility bank Account as per treasury guidelines Computerisation of HMIS Structural quality improvement since only facility with at least one star engaged in RBF 10 million TZS as start-up funds to improve facility infrastructure	Active Facility bank Account as per treasury guidelines Accountability mechanisms (FFARS and PlanRep) Deployment of accountants in health centres to support surrounding dispensaries. RHMT and CHMT supportive supervision

CHMT, Council Health Management Team; FFARS, Facility financial accounting and reporting system; HBF, Health Basket Fund; DHFF, Direct Health Facility Financing; HMIS, Health Management Information System; IAG, Internal Auditor General; MSD, Medical Stores Department; MOH, Ministry of Health; MOF, Ministry of Finance; NHIF, National Health Insurance Fund; P4P, Pay for performance; RAS, Regional administrative secretary; PlanRep, Planning and reporting system; PO-RALG, President’s Office, Regional Administration and Local Government; RHMTs, Regional Health Management Teams; RBF, Result Based Financing.