Mobile Money for Direct Facility Financing Moritz Piatti-Fünfkirchen Senior Economist The World Bank Group Health, Nutrition, Population Global Practice What is at stake? Frequently concerns from PETS and PERs include: � Funds don’t reach the frontlines (elite capture) and are delayed � Districts manage on behalf of facilities � Unclear how district support is distributed across providers � Providers travel long distances to collect cash � Limited accountability for facilities and districts “Financing environment is grossly � Limited report on use of funds inadequate for provision of quality � Inadequate autonomy for primary care.� providers Use of Mobile Money Is Widespread and Growing � Africa is fastest growing region for mobile money � > 400m registered mobile money accounts � > 60% of adult population have mobile money accounts � > 130 mobile money “Mobile money for cash transfers is common practice. Yet, it remains vastly providers underused to deliver funds to frontline service providers in health� Opportunities of Mobile Money Reach Mobile money will be used to send funds directly to facilities, even in otherwise hard to reach areas without banking services infrastructure. This provides access to essential funds where previously unavailable. Autonomy Facility will receive funds directly, granting them greater autonomy and flexibility on fund use. Previously they would rely on ‘in kind’ support from district administrations Stewardship The MOH will have full oversight over which facilities have received how much. A dashboard at the MOH will be set up through which transfers to providers are made. Real time funding adjustments can be made to reflect equity and need considerations. Transparency and Mobile money allows for automated reporting on actual use of funds at the facility level. Accountability Given the need to expedite financing and low financial management capacity at front line facilities, a digital audit trail is a significant advantage over the use of cash. Real time cash The MOH and DHMT will have full insight into the balance at the facility mobile wallets. management This allows them to understand cash flow needs and supports the efficient management of funds. Given Zambia’s fiscal and COVID crisis, it is important that balances can be shifted to where they are most urgently needed. Efficiency There are immediate efficiency gains to the health sector by strengthening PHC, reducing opportunities for corruption and elite capture, and extending greater autonomy to facilities. Further the use of mobile money is cheaper and less risky than the use of cash which will provide additional efficiency benefits. Exposure to Use of digital payments will reduce the need for human interaction and thereby the risk Covid19 for transmission of the virus. MOH Payment MOH Make Mobile Transfer to Facility Accounts Platform What Would Facility Mobile Facilities Receive Mobile a Mobile Wallets Balance in their Wallet Money Facilities Make Facilities pay suppliers through phone Solution Payments Facilities make transfers to staff Facilities cash out Look Like? Automatic Reporting on Transactions Introducing Mobile Money into Prevailing PFM Systems Mobile Money Accounts Allocation & Budget Planning No necessary change - Allocated grant amounts are transferred to MoH HG's 'bulk-payments disbursement account' with Issuance of Imprest provider's MM service provider's partner bank - MoH staff will access MM provider's online portal to upload file with each facility's mobile wallet number and allocation amount - The amount is deducted from MoH's 'bulk-payments disbursement account' and facilities will receive grants amounts instantaneously into their wallets, along with a notification SMS - Facilities can make purchases using their wallets accessible through mobile phones Purchasing - If needed, cash can be withdrawn from the nearest agent location - All payments must be based on payment vouchers supported by relevant documents and approvals, including suppliers’ invoice/ receipt / delivery note - Imprest retirement documents must be submitted by facilities to DHOs in monthly basis Retirement of Imprest - Monthly wallet account statements stating balances and transaction details should be downloaded from provider's portal and submitted as trails What Will it Take? Dedicated MOH Diagnostic team Setting up Contracting with systems in MOH DFS Providers Implementation Pilot locations modality Thank you