The role of health system context in the design and implementation of performance-based financing
Evidence from Cote d’Ivoire
Dados Bibliográficos
| ID | 21878591 |
|---|---|
| Autores | Denizhan Duran (0000-0001-7026-0447, World Bank Group, autor correspondente), Sebastian Bauhoff (0000-0001-6017-4991, Harvard Global Health Institute), Peter Berman (University of British Columbia), Tania Gaudet (Ministry of Health of Cote d'Ivoire, Abidjan, Côte d'Ivoire), Clovis Konan (Ministry of Health of Cote d'Ivoire, Abidjan, Côte d'Ivoire), Emre Ozaltin (Human Development, World Bank Group, Maputo, Mozambique), Margaret E Kruk (0000-0002-9549-8432, Harvard Global Health Institute) |
| Ano | 2020 |
| Volume | 5 |
| Fascículo | 9 |
| Páginas | e002934 |
| Data de publicação | 2020-09-01 |
| Peer Reviewed | Sim |
| Open Access | Sim |
| Tipo | ARTICLE |
| Periódico | BMJ Global Health (JOURNAL) |
| Identificadores do periódico | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Editora | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2020-002934 |
| PMID | 32999053 |
| OpenAlex | W3090397070 |
| Idioma | EN |
| Citações recebidas | 5 |
| Referências citadas | 27 |
Low quality of care is a significant problem for health systems in low-income and middle-income countries (LMICs). Policymakers are increasingly interested in using performance-based financing (PBF), a system-wide provider payment reform, conditioned on both quantity and quality of performance, to improve quality of care. The health system context influences both the design and the implementation of these programmes and thus their effectiveness. This study analyses how context has influenced the design and implementation of PBF in improving the quality of primary care in one particular setting, Cote d’Ivoire, a lower-middle income country with some of the poorest health outcomes in the world. Based on literature, an analytical framework was developed identifying five pathways through which financial incentives can influence the quality of primary care: earmarking, conditioning, provider behaviour, community involvement and management. Guided by this framework, semistructured interviews were conducted with policymakers and providers to diagnose the context and to assess the links between financing and quality of care at the primary care level. PBF in Cote d’Ivoire was found to have increased data availability and quality, facility-wide and disease-specific inputs, provider motivation and management practices in contracted facilities, but had limited success in improving process and outcome measures of quality, as well as community involvement and the provision of non-incentivised services. These limitations were attributable to a centralised health system structure constraining the decision space of health providers; financing and governance challenges across the health sector; and shortcomings with regard to the design of the PBF quality checklist and incentive structures in Cote d’Ivoire. In order to improve the quality of primary care, health sector reforms such as PBF should incorporate the organisational and service delivery context more broadly into their design and implementation, as is the case in other countries
Business · Corporate governance · Economic growth · Economics · Health care · Health services research · Incentive · Payment · Public economics · Global Maternal and Child Health · Healthcare Systems and Reforms · Primary Care and Health Outcomes · Finance
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| Obras citantes distintas | 5 |
|---|---|
| Citações por ano | 1,67 |
| Intervalo de citações | 2023 - 2025 (3) |
| Velocidade de citação | recent |
| Altamente citado | Não |
| Tipos de citação | Neutras: 5 |