The good, the bad, and the disruptive of performance- based financing on the Mozambican health system: results from a process evaluation

dc.creatorGergen, Jessica
dc.creatorRajkotia, Yogesh
dc.creatorRavishankar, Nirmala
dc.date2018-12-17
dc.date.accessioned2023-09-29T11:51:30Z
dc.date.available2023-09-29T11:51:30Z
dc.identifierhttps://revistas.ufg.br/fcs/article/view/56312
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/9096561
dc.descriptionA significant debate is unfolding around whether performance basedfinancing (PBF) is a mechanism of achieving broader health systems transformation. This study aims to contribute to this dialogue by assessing how PBF fostered positive, perverse and disruptive effects on the health system in two provinces of Mozambique. The study used qualitative methods to collect data in 24 PBF health facilities from 60+ health workers and facility administrators. PBF improved the facility’s work environment through improved local financial capacity and autonomy, resulting in greater planning. Health workers perceived incentives as a source of motivation, however the allocation of incentives among staff as unfair and lacking transparency. Major improvements in data qualityand completeness was observed in facility registers, verified quarterly. However, a heavier workload and enhanced focus on information systems were disruptive to time spent on clinical care. PBF remains a health systems strengthening intervention that results in targeted and program-driven changes that are not yet institutionalized or uniformly applied. Sustaining positive effects will requires greater focus on institutionalizing changes to governance, management structures, and financial autonomy, while enhancing inclusiveness of the  demand-side.en-US
dc.formatapplication/pdf
dc.languageeng
dc.publisherUniversidade Federal de Goiáspt-BR
dc.relationhttps://revistas.ufg.br/fcs/article/view/56312/26820
dc.rightsCopyright (c) 2018 Sociedade e Culturapt-BR
dc.sourceSociedade e Cultura; Vol. 21 No. 2 (2018)en-US
dc.sourceSociedade e Cultura; Vol. 21 Núm. 2 (2018)es-ES
dc.sourceSociedade e Cultura; v. 21 n. 2 (2018)pt-BR
dc.source1980-8194
dc.source1415-8566
dc.subjectPerformance-based financingen-US
dc.subjectResults-based financingen-US
dc.subjectHealth systems researchen-US
dc.subjectMozambiqueen-US
dc.subjectHealth system reformen-US
dc.titleThe good, the bad, and the disruptive of performance- based financing on the Mozambican health system: results from a process evaluationen-US
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typePeer-reviewed articles on a theme, given by guest editorsen-US


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