The good, the bad, and the disruptive of performance- based financing on the Mozambican health system: results from a process evaluation
| العنوان: | The good, the bad, and the disruptive of performance- based financing on the Mozambican health system: results from a process evaluation |
|---|---|
| المؤلفون: | Jessica Gergen, Yogesh Rajkotia, Nirmala Ravishankar |
| المصدر: | Sociedade e Cultura. 21 |
| بيانات النشر: | Universidade Federal de Goias, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Public economics, 030503 health policy & services, General Arts and Humanities, media_common.quotation_subject, Corporate governance, General Social Sciences, Workload, 03 medical and health sciences, Performance based financing, 0302 clinical medicine, Incentive, Transparency (graphic), 030212 general & internal medicine, Business, Process evaluation, Form of the Good, 0305 other medical science, Autonomy, media_common |
| الوصف: | A 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. |
| تدمد: | 1980-8194 1415-8566 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::97360b433cba0028eed856939dc395a7Test https://doi.org/10.5216/sec.v21i2.56312Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi...........97360b433cba0028eed856939dc395a7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19808194 14158566 |
|---|