The Good, the Bad, and the Disruptive of Performance-Based Financing on the Mozambican Health System: Results from a process evaluation

Gergen, Jessica; Rajkotia, Yogesh; Ravishankar, Nirmala

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dc.creator	Gergen, Jessica
dc.creator	Rajkotia, Yogesh
dc.creator	Ravishankar, Nirmala
dc.date	2018
dc.date.accessioned	2023-03-28T19:00:22Z
dc.date.available	2023-03-28T19:00:22Z
dc.identifier	1415-8566
dc.identifier	https://www.redalyc.org/articulo.oa?id=70358824027
dc.identifier.uri	https://biblioteca-repositorio.clacso.edu.ar/handle/CLACSO/241384
dc.description	"A significant debate is unfolding around whether performance- based financing (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 quality and 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."
dc.format	application/pdf
dc.language	en
dc.publisher	Universidade Federal de Goiás
dc.relation	http://www.redalyc.org/revista.oa?id=703
dc.rights	Sociedade e Cultura
dc.source	Sociedade e Cultura (Brasil) Num.2 Vol.21
dc.subject	Multidisciplinarias (Ciencias Sociales)
dc.subject	results
dc.subject	Mozambique
dc.subject	Performance
dc.subject	based financing
dc.subject	based financing
dc.title	The Good, the Bad, and the Disruptive of Performance-Based Financing on the Mozambican Health System: Results from a process evaluation
dc.type	artículo científico