After more than a year of hard work, and months of testing and improvement, we are very pleased to officially release the new ORBF tool to help manage RBF and strategic purchasing on top of DHIS2 platforms.

Since 2012, Bluesquare has been developing and deploying OpenRBF in many countries. OpenRBF was a separate and stand alone software platform. In 2016, we decided to re-build the software, and split it into several modules, while maintaining our focus on technology that would enhance the health financing capability of DHIS2. This led to the development of three software modules that are plugged into DHIS2: DataCollect (an ODK to DHIS2 offline mobile android app), DataViz (a data visualisation interface used for RBF portals), and ORBF, a health financing rule engine.

Over the coming months we will share more on these modules. For today we will focus on ORBF and its great capabilities.

ORBF features :

  • ORBF helps you to define which facilities are eligible for a financing scheme. You can select facilities per group, per type, or per unit. In the example below, 401 facilities out of 1956 are part of the RBF scheme in Zimbabwe.                                                                                                                                
  • It also allows you to define, build, manage and visualise the health financing benefit package. A benefit package is composed of multiple services, services that are often themselves a combination of multiple data elements. ORBF helps you to structure your benefit package. Each one is then associated with specific health facilities and specific variables (e.g. fees). You can also define whether you use declared, verified or validated data for your service definition. 

As an example, the screenshot of the benefit package purchased by RBF for health centers in Zimbabwe can be accessed here, and that of a quantity package including items for which health centers receive payments is visible here.

  • ORBF helps you to define the computations and rules that apply to the payment formula. ORBF supports equations that cannot be computed in DHIS2, such as: if, then statements, % difference between data from two periods, combination of data from two periods, threshold measurements, etc. The tool supports quality of care computations, patient satisfaction computations, payment computations, equity measurement, performance measurement, claim computation based on multiple data elements and indicators stored in DHIS2. Intermediary and final computed outputs are returned as data elements to DHIS2 where they are then stored. Each rule is stored and attached to the data so that results and claims can be audited over time, even if the rule has changed.
  • You can see here an example of how you edit rules, and here a more visual example of the interdependencies between each of the formulas and the calculations between them.
  • The tool logs every change in the benefit package or the payment rules, and allows the users to monitor these changes over time.
  • Finally, ORBF can help you define, test, validate and generate claims reports, payment orders in DHIS2. (See an example of a claim here).  

ORBF is an OpenSource tool, and is available and maintained here : https://github.com/BLSQ/orbf2

If you want to learn more about ORBF, and understand how this tool can help you with Result-Based Financing, strategic purchasing on top of DHIS2, or other complex computations, do not hesitate to contact us.   

How ORBF brings added value in Cameroon.  

Over the last few months, Cameroon’s PBF Program upgraded their data system from the former PBF data management system, OpenRBF, to the new and improved ORBF.  This transition included an overhaul of the existing data system to migrate the program to Bluesquare’s new modularized architecture. ORBF now provides the PBF team with a more flexible system to meet their program needs and a greater level of autonomy so that they can update their system themselves as the program evolves.

Matching our technology to the individual context

Each national PBF program has its unique organisational elements to take into consideration. Cameroon’s new PBF system uses DHIS2 as the central data management system and Bluesquare’s suite of products to improve how data is collected, managed, and then visualized. ORBF, Bluesquare’s computational rules engine, supports calculations that could otherwise not be computed and stored in DHIS2.

Cameroon’s PBF program required to develop new features for ORBF. In Cameroon, ORBF had to support a use case where facilities are split into groups of contracted and sub-contracted facilities. A primary facility is responsible for helping the sub-contracted facilities improve their performance. Performance is measured for each facility, and then the contracted groups of facilities, by applying a set of equations to the  number of services provided and scores from routine quality assessments.

With ORBF, the program is able to establish a set of rules to manage attribution of services,  calculates cores, and allocate program funds. It then sends back the information as singular data elements, so that they can be easily used for analysis and included in DHIS2 reports. Now, as the program evolves, new facilities can be added, or contract groups can be added or changed. For instance, a facility’s status can be changed from subcontracted to primary facility, based on performance, or vice versa. Now, with the upgraded system, the PBF data management team in Cameroon is able to manage its system independently and autonomously with limited support from Bluesquare.

Written by Tamara Goldschmidt, Program and Partnership Lead at BlueSquare. Find her on LinkedIn and Twitter.

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