Cargando…

Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing

Background: Numerous countries have undertaken performance-based financing (PBF) reforms to improve quality and quantity of healthcare services. However, only few reforms have successfully managed to achieve the different scale-up phases. In Burkina Faso, a pilot project was implemented, but was put...

Descripción completa

Detalles Bibliográficos
Autores principales: Seppey, Mathieu, Ridde, Valéry, Somé, Paul-André
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309920/
https://www.ncbi.nlm.nih.gov/pubmed/33201654
http://dx.doi.org/10.34172/ijhpm.2020.209
_version_ 1784753277757292544
author Seppey, Mathieu
Ridde, Valéry
Somé, Paul-André
author_facet Seppey, Mathieu
Ridde, Valéry
Somé, Paul-André
author_sort Seppey, Mathieu
collection PubMed
description Background: Numerous countries have undertaken performance-based financing (PBF) reforms to improve quality and quantity of healthcare services. However, only few reforms have successfully managed to achieve the different scale-up phases. In Burkina Faso, a pilot project was implemented, but was put on hold before being scaled. During the writing of this article, discussions to scale-up were still ongoing on a national strategic purchasing strategy within a government led user fee exemption policy. Methods: This study’s objective is to identify facilitators and barriers to scaling-up for that pilot, based on the World Health Organization’s (WHO’s) theoretical framework. Interviews were conducted in three health centres and in Ouagadougou to discuss the scale-up with different actors. The software QDA Miner© was used to help in the framework analysis. Results: The low involvement of some key stakeholders (mainly decision-makers) and the unstable context hindered ownership of the project, thus its priority on the political agenda. PBF reform therefore lost its momentum to the benefit of a user fee exemption policy. This latter program was seen to be more beneficial since it addressed access to healthcare services, in comparison to service quality, which was the PBF’s relative advantage. A scale-up of some PBF elements (eg, strategic purchasing tools) is however still in discussion in 2019, but would be integrated within the user fee exemption program. Increased costs during the PBF’s implementation gave the impression that the project was too costly and not scalable. The involvement of an important funding agency (World Bank, WB) also fed the impression of high costs, which demotivated the actors, especially decision-makers. Conclusion: Contextual factors remain central to the implementation of PBF, while their evaluation and mitigation have remained unclear. The participation of key actors in scaling-up operations and the use of social science as tools to better understand the context is therefore primordial.
format Online
Article
Text
id pubmed-9309920
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Kerman University of Medical Sciences
record_format MEDLINE/PubMed
spelling pubmed-93099202022-08-09 Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing Seppey, Mathieu Ridde, Valéry Somé, Paul-André Int J Health Policy Manag Original Article Background: Numerous countries have undertaken performance-based financing (PBF) reforms to improve quality and quantity of healthcare services. However, only few reforms have successfully managed to achieve the different scale-up phases. In Burkina Faso, a pilot project was implemented, but was put on hold before being scaled. During the writing of this article, discussions to scale-up were still ongoing on a national strategic purchasing strategy within a government led user fee exemption policy. Methods: This study’s objective is to identify facilitators and barriers to scaling-up for that pilot, based on the World Health Organization’s (WHO’s) theoretical framework. Interviews were conducted in three health centres and in Ouagadougou to discuss the scale-up with different actors. The software QDA Miner© was used to help in the framework analysis. Results: The low involvement of some key stakeholders (mainly decision-makers) and the unstable context hindered ownership of the project, thus its priority on the political agenda. PBF reform therefore lost its momentum to the benefit of a user fee exemption policy. This latter program was seen to be more beneficial since it addressed access to healthcare services, in comparison to service quality, which was the PBF’s relative advantage. A scale-up of some PBF elements (eg, strategic purchasing tools) is however still in discussion in 2019, but would be integrated within the user fee exemption program. Increased costs during the PBF’s implementation gave the impression that the project was too costly and not scalable. The involvement of an important funding agency (World Bank, WB) also fed the impression of high costs, which demotivated the actors, especially decision-makers. Conclusion: Contextual factors remain central to the implementation of PBF, while their evaluation and mitigation have remained unclear. The participation of key actors in scaling-up operations and the use of social science as tools to better understand the context is therefore primordial. Kerman University of Medical Sciences 2020-11-09 /pmc/articles/PMC9309920/ /pubmed/33201654 http://dx.doi.org/10.34172/ijhpm.2020.209 Text en © 2022 The Author(s); Published by Kerman University of Medical Sciences https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Seppey, Mathieu
Ridde, Valéry
Somé, Paul-André
Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing
title Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing
title_full Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing
title_fullStr Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing
title_full_unstemmed Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing
title_short Scaling-Up Performance-Based Financing in Burkina Faso: From PBF to User Fees Exemption Strategic Purchasing
title_sort scaling-up performance-based financing in burkina faso: from pbf to user fees exemption strategic purchasing
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309920/
https://www.ncbi.nlm.nih.gov/pubmed/33201654
http://dx.doi.org/10.34172/ijhpm.2020.209
work_keys_str_mv AT seppeymathieu scalingupperformancebasedfinancinginburkinafasofrompbftouserfeesexemptionstrategicpurchasing
AT riddevalery scalingupperformancebasedfinancinginburkinafasofrompbftouserfeesexemptionstrategicpurchasing
AT somepaulandre scalingupperformancebasedfinancinginburkinafasofrompbftouserfeesexemptionstrategicpurchasing