Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso

Implementation Science

Manuela De Allegri⁴  Sylvie Zongo¹  Matthew Hunt⁵  Hervé Hien³  Maurice Yaogo²  Jean Louis Koulidiati⁴  David Zombré⁶  Julia Lohmann⁴  Aurélia Souares⁴  Anne-Marie Turcotte-Tremblay⁶  Valéry Ridde⁶ 

[1] Institut des Sciences des Sociétés (INSS-CNRST), Ouagadougou, 03 BP 7047, Burkina Faso;AFRICSanté & Université Catholique de l¿Afrique de l¿Ouest - Unité Universitaire de Bobo-Dioulasso, Bobo-Dioulasso, 01 BP 298, Burkina Faso;Institut de recherche en sciences de la santé (IRSS) du CNRST, Ouagadougou, 03 BP 7192 03, Burkina Faso;Institute of Public Health, Medical Faculty, Heidelberg University, Im Neuenheimer Feld 324, Heidelberg, 69120, Germany;School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir William Osler, 2nd Floor, Montréal QC H3G 1Y5, Canada;University of Montreal School of Public Health, 7101 Avenue du Parc, 3rd Floor, Montréal QC H3N 1X9, Canada

关键词: Research protocol;    Case study methodology;    Process evaluation;    Implementation study;    Burkina Faso;    Equity;    User fee exemption;    Community-based health insurance;    Performance-based financing;   

Others  :  1139528
DOI  :  10.1186/s13012-014-0149-1

 received in 2014-08-25, accepted in 2014-09-19,  发布年份 2014

【 摘 要 】

Background

The low quality of healthcare and the presence of user fees in Burkina Faso contribute to low utilization of healthcare and elevated levels of mortality. To improve access to high-quality healthcare and equity, national authorities are testing different intervention arms that combine performance-based financing with community-based health insurance and pro-poor targeting. There is a need to evaluate the implementation of these unique approaches. We developed a research protocol to analyze the conditions that led to the emergence of these intervention arms, the fidelity between the activities initially planned and those conducted, the implementation and adaptation processes, the sustainability of the interventions, the possibilities for scaling them up, and their ethical implications.

Methods/Design

The study adopts a longitudinal multiple case study design with several embedded levels of analyses. To represent the diversity of contexts where the intervention arms are carried out, we will select three districts. Within districts, we will select both primary healthcare centers (n =18) representing different intervention arms and the district or regional hospital (n =3). We will select contrasted cases in relation to their initial performance (good, fair, poor). Over a period of 18 months, we will use quantitative and qualitative data collection and analytical tools to study these cases including in-depth interviews, participatory observation, research diaries, and questionnaires. We will give more weight to qualitative methods compared to quantitative methods.

Discussion

Performance-based financing is expanding rapidly across low- and middle-income countries. The results of this study will enable researchers and decision makers to gain a better understanding of the factors that can influence the implementation and the sustainability of complex interventions aiming to increase healthcare quality as well as equity.

【 授权许可】

   
2014 Ridde et al.; licensee BioMed Central Ltd.

【 图 表 】

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