A study on the implementation fidelity of the performance-based financing policy in Burkina Faso after 12 months
A study on the implementation fidelity of the performance-based financing policy in Burkina Faso after 12 months
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DOI：
10.1186/s13690-017-0250-4
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发表时间：
2018-01-11
影响因子：
3.3
通讯作者：
Ridde, Valery
中科院分区：
文献类型：
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作者：
Bodson, Oriane;Barro, Ahmed;Ridde, Valery
背景资料：卫生部门基于绩效的融资（PBF）最近在低收入和中等收入国家（LMIC）获得了发展势头，成为实现全民健康覆盖的一种方式。PBF的主要原则是，保健中心根据其提供服务的数量和质量获得报酬。PBF自2011年以来一直在布基纳法索运作，并自2014年以来在15个卫生区作为试点项目随机分配到四个不同的模式，最终扩大规模。尽管需要迅速记录建设和平基金的影响，但建议谨慎行事，避免仓促作出结论。最重要的是，必须了解产生或不产生影响的原因和方式。我们的实施保真度的研究接近这一调查比较，经过12个月的运作，对什么是最初计划的活动实施，并将有可能在以后建立联系的政策的impactions.Methods：我们的研究比较，在21个卫生中心从三个卫生区，活动的实施，核心的过程中的内容，覆盖面和时间性。通过文件分析，以及从个人访谈和焦点小组与关键informants.Results收集数据：在实施的第一年，坚实的基础到位的干预。即便如此，在某些绩效审计程序以及建设和平基金补贴的支付方面也发现了执行缺陷和延误，这在一定程度上损害了基于激励的理由。
Background: Performance-based financing (PBF) in the health sector has recently gained momentum in low-and middle-income countries (LMICs) as one of the ways forward for achieving Universal Health Coverage. The major principle underlying PBF is that health centers are remunerated based on the quantity and quality of services they provide. PBF has been operating in Burkina Faso since 2011, and as a pilot project since 2014 in 15 health districts randomly assigned into four different models, before an eventual scale-up. Despite the need for expeditious documentation of the impact of PBF, caution is advised to avoid adopting hasty conclusions. Above all, it is crucial to understand why and how an impact is produced or not. Our implementation fidelity study approached this inquiry by comparing, after 12 months of operation, the activities implemented against what was planned initially and will make it possible later to establish links with the policy's impacts.Methods: Our study compared, in 21 health centers from three health districts, the implementation of activities that were core to the process in terms of content, coverage, and temporality. Data were collected through document analysis, as well as from individual interviews and focus groups with key informants.Results: In the first year of implementation, solid foundations were put in place for the intervention. Even so, implementation deficiencies and delays were observed with respect to certain performance auditing procedures, as well as in payments of PBF subsidies, which compromised the incentive-based rationale to some extent.Conclusion: Over next months, efforts should be made to adjust the intervention more closely to context and to the original planning.