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This manual provides comprehensive guidelines for implementing Performance-Based Financing (PBF) in Rwandan health facilities, including hospitals and health centers. It outlines the principles, structures, and operational procedures of the PBF system, designed to enhance healthcare quality and accessibility by incentivizing performance. Topics include contract management, performance indicators, budgeting, payment cycles, evaluation methodologies, and monitoring frameworks. By aligning financial incentives with measurable health outcomes, this manual supports health facilities in delivering improved services to communities, while ensuring accountability and sustainability within Rwanda’s health system.