Why Performance-Based Financing in Chad Failed to Emerge on the National Policy Agenda

Health Systems & Reform

卷:3

Zubin Cyrus Shroff¹  Joël Arthur Kiendrébéogo²  Abdramane Berthé²  Mahamat Béchir³  Lamoudi Yonli³  Bruno Meessen⁴ 

[1] Alliance for Health Policy and Systems Research, World Health Organization;

[2] Centre MURAZ;

[3] Centre de Support en Santé Internationale;

[4] Institute of Tropical Medicine;

关键词: africa;    agenda setting;    chad;    kingdon;    multiple streams approach;    performance-based financing;    pilot;    policy analysis;    policy nonemergence;   

DOI  :  10.1080/23288604.2017.1280115

来源: DOAJ

【 摘 要 】

Abstract—Supported by the World Bank (WB), Chad implemented a performance-based financing (PBF) scheme as a pilot, from October 2011 to May 2013. However, despite promising results and the government's stated commitment to ensure its continuation after the World Bank's departure, PBF failed to come onto the national policy agenda. This article aims to explain why this was the case, an especially interesting question given that several factors were favorable for project continuation. Data for this case study were collected through literature review and key informant interviews. We applied Kingdon's agenda setting theory to explain this failure. We found that though the potential of PBF to address challenges facing the Chadian health system was confirmed by internal and external evaluations of the pilot, it failed to move from the governmental agenda to the decision agenda. The main reason was a lack of dedicated policy entrepreneurs, resulting in a weak actual ownership of the policy by national authorities and key stakeholders. We tried to understand why such policy entrepreneurs failed to emerge.

【 授权许可】

Unknown