This Discussion Paper presents theapproach, findings, and recommendations from a desk reviewof the qualitative research conducted within Results-BasedFinancing programmes (RBF) under the Health ResultsInnovations Trust Fund (HRITF). The review included 17studies conducted in Benin, Burundi, Cameroon, DRC,Ethiopia, Haiti, Kenya, Kyrgyzstan, Nigeria, Rwanda,Tajikistan, Tanzania, Zambia, and Zimbabwe. The studiesreveal a body of high quality work that is consistent withthe conceptual framework of RBF schemes, supported bypolitical will, resources, and research capacity.Strengthening the added value of qualitative inquiry inon-going and future qualitative studies may be enabled bysmall shifts in thinking and practice, in line with aqualitative research paradigm. First, in order to betterground research in an existing country and system specificcontext, some interrogation of constructs and positedrelationships in the existing conceptual framework forintervention/evaluation may be required. Second, to enablemore in-depth and richer data that documents workingpractices and relations under RBF schemes, training of localresearchers should place stronger emphasis on entry to thefield, gaining trust, building rapport, and sustaining adialogue with key informants. Third, smaller, more intensiveand focused studies targeting fewer sites and smallersamples - but addressing a wider range of methods andinformants within the health system - are likely to yieldricher data that can support the understanding of how healthworkers and managers are responding to schemes, and whatimpact schemes have on service volumes and outputs.
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