Donor-funded project's sustainability assessment

A qualitative case study of a results-based financing pilot in Koulikoro region, Mali

Dados Bibliográficos

ID19534735
AutoresMathieu Seppey (0000-0002-3897-9168, Institut National de Santé Publique du Québec, autor correspondente), Valery Ridde (0000-0001-9299-8266, Institut National de Santé Publique du Québec), Laurence Touré (0000-0002-0109-8906, Mali-Folkecenter), Abdourahmane Coulibaly (0000-0002-2224-3615, Mali-Folkecenter)
Ano2017
Volume13
Fascículo1
Páginas86-86
Data de publicação2017-12-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoGlobalization and Health (JOURNAL)
Identificadores do periódicoISSN: 1744-8603 • E-ISSN: 1744-8603
EditoraSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12992-017-0307-8
PMID29216877
OpenAlexW2768653505
IdiomaEN
Citações recebidas14
Referências citadas40

BACKGROUND: Results-based financing (RBF) is emerging as a new alternative to finance health systems in many African countries. In Mali, a pilot project was conducted to improve demand and supply of health services through financing performance in targeted services. No study has explored the sustainability process of such a project in Africa. This study's objectives were to understand the project's sustainability process and to assess its level of sustainability. METHODS: Sustainability was examined through its different determinants, phases, levels and contexts. These were explored using qualitative interviews to discern, via critical events, stakeholders' ideas regarding the project's sustainability. Data collection sites were chosen with the participation of different stakeholders, based on a variety of criteria (rural/urban settings, level of participation, RBF participants still present, etc.). Forty-nine stakeholders were then interviewed in six community health centres and two referral health centres (from 11/12/15 to 08/03/16), including health practitioners, administrators, and those involved in implementing and conceptualizing the program (government and NGOs). A theme analysis was done with the software © QDA Miner according to the study's conceptual framework. RESULTS: The results of this project show a weak level of sustainability due to many factors. While some gains could be sustained (ex.: investments in long-term resources, high compatibility of values and codes, adapted design to the implementations contexts, etc.) other intended benefits could not (ex.: end of investments, lack of shared cultural artefacts around RBF, loss of different tasks and procedures, need of more ownership of the project by the local stakeholders). A lack of sustainability planning was observed, and few critical events were associated to phases of sustainability. CONCLUSIONS: While this RBF project aimed at increasing health agents' motivation through different mechanisms (supervision, investments, incentives, etc.), these results raise questions on what types of motivation could be more stable and what could be the place of local stakeholders in the project; all this with the aim of more sustained and efficient results

Business · Economic growth · Economics · Environmental resource management · Health care · Health services research · Implementation · Political science · Public relations · Qualitative research · Sociology · Sustainability · Engineering · Global Maternal and Child Health · Health Policy Implementation Science · Health Systems, Economic Evaluations, Quality of Life