Investigating the determinants of health worker performance in Senegal

调查塞内加尔卫生工作者绩效的决定因素

• 批准号: MR/M014681/1
• 负责人: Mylene Lagarde
• 金额: $ 63.83万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2015
• 资助国家: 英国
• 起止时间: 2015 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FM014681%2F1
• 关键词: Investigating; determinants; health; worker; performance

Training, motivating and retaining professional health workers is crucial for the improvement of health outcomes, especially in low and middle-income countries where poor health worker performance has been recognised as one of the key obstacles to achieving better health outcomes. To improve staff motivation and performance, many donors and governments have recently supported the introduction of Performance-Based Financing (PBF) mechanisms, which link part of the health workers' remuneration to performance targets. While promising results have shown that these programmes can improve utilisation of health services and some health outcomes, it is still unclear what specific effects they have on the motivation and behaviours of health workers. Yet it is key to understand better how PBF works for health workers, and in particular whether all aspects of health workers' performance have improved or whether PBF can induce some undesired effects, e.g. a reduction in time spent with each patient.The aim of the proposed research is to generate new knowledge and understanding of how PBF programmes work and influence health workers' performance. The proposed research takes advantage of a quasi-experimental study introduced by the World Bank in four of the poorest and most rural regions of Senegal in 2014. The project will collect a rich set of primary data in control and PBF facilities to answer several critical questions.The research will first undertake some interviews to assess whether the extent to which what was planned in the PBF scheme is actually what is happening in practice. This will help understand exactly the nature of the intervention being implemented. The research will then undertake a large survey, collecting information in control and PBF facilities on the working environment and characteristics, behaviours and performance of health care workers. The aim is to determine the effects of PBF, by comparing the performance and behaviours of health workers with and without PBF incentives. Specifically, the survey will explore whether PBF improves the productivity, quality of care provided and attitude towards patients. The data collected will also help determine whether the time and effort spent on each patient increase and on non-incentivised activities decrease as a result of the PBF. Finally, with the information collected, we will be able to identify mechanisms through which the performance of health workers changes.

培训、激励和留住专业卫生工作者对于改善卫生成果至关重要，特别是在低收入和中等收入国家，在这些国家，卫生工作者绩效不佳已被认为是实现更好卫生成果的主要障碍之一。为了提高工作人员的积极性和绩效，许多捐助者和政府最近支持采用基于绩效的筹资机制，将卫生工作者的部分薪酬与绩效目标挂钩。虽然有希望的结果表明，这些规划可以改善卫生服务的利用和一些健康结果，但仍不清楚它们对卫生工作者的动机和行为有什么具体影响。然而，关键是要更好地了解PBF如何对卫生工作者起作用，特别是卫生工作者绩效的各个方面是否都得到了改善，或者PBF是否会产生一些意想不到的影响，例如减少与每个病人相处的时间。拟议研究的目的是对PBF规划如何发挥作用和影响卫生工作者绩效产生新的认识和理解。这项拟议的研究利用了世界银行2014年在塞内加尔四个最贫困和最农村地区开展的一项准实验性研究。该项目将收集控制和PBF设施的丰富原始数据，以回答几个关键问题。该研究将首先进行一些访谈，以评估PBF计划中计划的内容是否在实践中实际发生的程度。这将有助于准确理解正在实施的干预措施的性质。然后，该研究将进行一项大型调查，在控制和PBF设施中收集关于卫生保健工作者的工作环境和特点、行为和绩效的信息。目的是通过比较有和没有PBF激励的卫生工作者的绩效和行为，确定PBF的影响。具体而言，调查将探讨PBF是否提高了生产力、提供的护理质量和对患者的态度。收集的数据还将有助于确定PBF是否增加了花在每位患者身上的时间和精力，而减少了花在非激励活动上的时间和精力。最后，根据收集到的信息，我们将能够确定使卫生工作者的绩效发生变化的机制。

项目成果

Can patients improve the quality of care they receive? Experimental evidence from Senegal.

• DOI: 10.1016/j.worlddev.2021.105740
• 发表时间: 2022-03
• 期刊: World development
• 影响因子: 6.9
• 作者: Kovacs RJ;Lagarde M;Cairns J
• 通讯作者: Cairns J

Overconfident health workers provide lower quality healthcare

• DOI: 10.1016/j.joep.2019.102213
• 发表时间: 2020-01-01
• 期刊: JOURNAL OF ECONOMIC PSYCHOLOGY
• 影响因子: 3.5
• 作者: Kovacs, Roxanne J.;Lagarde, Mylene;Cairns, John
• 通讯作者: Cairns, John

Does high workload reduce the quality of healthcare? Evidence from rural Senegal.

• DOI: 10.1016/j.jhealeco.2022.102600
• 发表时间: 2022-03
• 期刊: JOURNAL OF HEALTH ECONOMICS
• 影响因子: 3.5
• 作者: Kovacs, Roxanne;Lagarde, Mylene
• 通讯作者: Lagarde, Mylene