Does training on performance based financing make a difference in performance and quality of health care delivery? Health care provider’s perspective in Rungwe Tanzania

BMC Health Services Research

Bernard Njau¹  Saria Salome²  Joachim Kessy¹  Declare Mushi¹  Rachel Manongi¹ 

[1] Kilimanjaro Christian Medical University College, P. O. Box 2240, Kilimanjaro, Tanzania;Kilimanjaro Christian Medical Centre, P. O. Box 3010, Kilimanjaro, Tanzania

关键词: Tanzania;    Rungwe;    PBF pilot project;    Performance based financing;   

Others  :  1132800
DOI  :  10.1186/1472-6963-14-154

 received in 2013-05-21, accepted in 2014-03-31,  发布年份 2014

【 摘 要 】

Background

In recent years, Performance Based Financing (PBF); a form of result based financing, has attracted a global attention in health systems in developing countries. PBF promotes autonomous health facilities, motivates and introduces financial incentives to motivate health facilities and health workers to attain pre-determined targets. To achieve this, the Tanzanian government through the Christian Social Services Commission initiated a PBF pilot project in Rungwe district, Mbeya region. Kilimanjaro Christian Medical Center was given the role of training health workers on PBF principles in Rungwe. The aim of this study was to explore health care providers’ perception on a three years training on PBF principles in a PBF pilot project at Rungwe District in Mbeya, Tanzania.

Methods

This was an explorative qualitative study, which took place at Rungwe PBF pilot area in October 2012. Twenty six (26) participants were purposively selected. Six took part in- depth interviews (IDIs) and twenty (20) in the group discussions. Both the IDIs and the GDs explored the perceived benefit and challenges of implementing PBF in their workplace. Data were manually analyzed using content analysis approach.

Results

Overall informants had positive perspectives on PBF training. Most of the health facilities were able to implement some of the PBF concepts in their work places after the training, such as developing job descriptions for their staff, creating quarterly business plans for their facilities, costing for their services and entering service agreement with the government, improved record keeping, customer care and involving community as partners in running their facilities. The most common principle of paying individual performance bonuses was mentioned as a major challenge due to inadequate funding and poor design of Rungwe PBF pilot project.

Conclusion

Despite poor design and inadequate funding, our findings have shown some promising results after PBF training in the study area. The findings have highlighted the potential of PBF to act as leverage for initiating innovative and proactive actions, which may motivate health personnel performance and quality of care in the study setting with minimal support. However, key policy issues at the national level should be addressed in order to exploit this opportunity.

【 授权许可】

   
2014 Manongi et al.; licensee BioMed Central Ltd.

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