Results-based financing for equitable access to maternal and child health care in Mali and Burkina Faso (IMCHA)
Programs and partnerships
Lead institution(s)
Summary
In Mali and Burkina Faso, maternal and child mortality rates remain high. The governments of both countries are trying to increase access to and use of health care for women and children.Read more
In Mali and Burkina Faso, maternal and child mortality rates remain high. The governments of both countries are trying to increase access to and use of health care for women and children. They have adopted policies to remove financial barriers and are now piloting results-based financing, which gives financial incentives to providers of health services for achieving predefined indicators. Despite these efforts, health inequalities persist.
This project will contribute to increasing equitable access to health services for the poor by strengthening the implementation of health reforms in Mali and Burkina Faso. It examines the emergence, relevance, design, and development of results-based financing in both countries, and studies its implementation, sustainability, and efficacy. The project will also look at the impact of results-based financing on health providers' motivation and teamwork, local leadership, community management committees of health facilities, access to and use of health services, and financial protection of vulnerable populations. It will document any unexpected outcomes.
The project will result in a number of scientific publications from established and young researchers. In addition, the results of the study will be disseminated to decision-makers across Africa and to international agencies involved in the design and scale-up of results-based financing for maternal and child health.
This project is part of the Innovating for Maternal and Child Health in Africa (IMCHA) Initiative, a seven year, $CA36 million multi-donor partnership funded by Global Affairs Canada, the Canadian Institutes of Health Research, and Canada's International Development Research Centre.
Research outputs
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This research analyzes the process of implementing performance-based financing (PBF) at district hospital (DH) level in Mali. Problems such as malfunctioning management bodies, or mobilizing staff for meetings prevented adequate implementation of PBF. Communication channels and tools were defective in the vast majority of DHs. In addition, there were problems in motivation of health workers. The article provides background to PBF initiatives and examines specific data in relation to district hospitals. Performance-based financing (PBF) is a mechanism whereby health facilities are paid on the basis of their performance, which is measured by the quantity and quality of services they provide.
The study findings revealed that the internal context of performance-based financing (PBF) implementation played a key role in the process of improving health system performance. High-performing primary healthcare facilities exercised leadership and commitment. These two characteristics were associated with taking initiatives to promote PBF implementation and strengthening team spirit. The PBF project in Mali discussed in this article was funded by the World Bank as part of a larger initiative towards improved reproductive health. With few exceptions, PBF was perceived as a complicated intervention to implement, partly because of data management procedures.
