Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin

Agonnoude Togbédji Maurice; Houeto Sègbegnon David; Sambieni N’koué Emmanuel; Adoukonou Tododjitché Thierry Armel

doi:doi:10.11648/j.cajph.20200605.18

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Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin

Agonnoude Togbédji Maurice, Houeto Sègbegnon David, Sambieni N’koué Emmanuel, Adoukonou Tododjitché Thierry Armel

Published in Central African Journal of Public Health (Volume 6, Issue 5)

Received: 3 September 2020 Accepted: 22 September 2020 Published: 7 October 2020

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Abstract

Background: two pilot studies of RBF have been conducted in some health districts of Benin since 2012, which results have been scaled up in 2015. Then, it’s important to see whether the impacts of health care from those studies will be confirmed by HFs performance in IS. Objective: to analyze the impact of RBF on IS performance in Parakou/N’dali and Nikki/Kalalé/Pèrèrè health districts, through the quality of the structure and the process of supplying these services, and their possible association with the immunization services performance. Method: A retrospective study was conducted including all public and private functional HFs covered by the period of 14 trimesters (T1 2014 to T2 2017). The dependent variable was the performance in IS. The independent variables were the quality of the structure, the quality of the process and the environment. A linear regression model was adjusted; the significance threshold was 5%. Results: 55 HFs participated to the study; they were mostly in rural areas (76.4%) and 36.4% were at the first level of the pyramid. There was no improvement in both trained staff (p=0.67) and midwifery staff (p=0.75) and in the rest of the structure (p=0.697); however there was a significant improvement in supplying process of immunization services (p=0.001) and the performance in IS (p=0.010). In multivariate analysis, overall and in cluster by area analysis, models were not significant. Conclusion: RBF act only on the processes of supplying immunization services to improve HF performance, taking into account the environment. No explained factors were found for this performance improvement. Local dynamics in each HF should be in action which can be uncover in interactions with local actors.

Published in	Central African Journal of Public Health (Volume 6, Issue 5)
DOI	10.11648/j.cajph.20200605.18
Page(s)	293-298
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Immunization, Results Based Financing, Healthcare Quality, Structure, Process, Benin

References

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[3]	Projet de renforcement de la performance du système de santé (PRPSS). Mise à échelle du FBR: pari gagné pour le Bénin: les 34 zones sanitaires couvertes à compter de juin 2015. Bulletin d’Information électronique du Projet de Renforcement de la Performance du Système de Santé, March 2015.
[4]	Paul E, Dramé ML, Kashal J-P, et al. Performance-based financing to strengthen the health system in Benin: challenging the mainstream approach. Int J Health Policy Manag 2017; 6: 1–13.
[5]	Restrepo-Méndez MC, Barros AJ, Wong KL, et al. Inequalities in full immunization coverage: trends in low- and middle-income countries. Bull World Health Organ 2016; 2016: 794-805A.
[6]	République du Bénin. Cinquième Enquête Démographique et de Santé 2017-2018. Cotonou, Rockville, Maryland, USA: INSAE et ICF.: INSAE, MPD, Juillet 2018.
[7]	République du Bénin, Ministère de la Santé. Plan national de développement sanitaire 2018-2022.
[8]	Rudasingwa M, Soeters R, Basenya O. The effect of performance-based financing on maternal healthcare use in Burundi: a two-wave pooled cross-sectional analysis. Glob Health ACTION 2017; 10: 1–10.
[9]	Fonds fiduciaire pour l’innovation en matière de résultats de santé (HRITF). Obtenir des résultats pour la santé des femmes et des enfants. Intermediary Report, New York: World Bank Group, 2015.
[10]	Ndikubagenzi J, Nzeyimana É, Gahungere O, et al. Comparaison de l’utilisation des méthodes contraceptives modernes cinq ans avant et cinq ans après mise à échelle du financement basé sur la performance au Burundi. Bujumbura: Share. net, October 2017.
[11]	Bonfrer I, Van de Poel E, Van Doorslaer E. The effects of performance incentives on the utilization and quality of maternal and child care in Burundi. Soc Sci Med 2014; 123: 96–104.
[12]	Mussah VG, Mapleh L, Ade S, et al. Performance-based financing contributes to the resilience of health services affected by the Liberian Ebola outbreak. Public Health Action 2017; 7: 100–105.
[13]	Eldridge C, Palmer N. Performance-based payment: some reflections on the discourse, evidence and unanswered questions. Health Policy Plan 2009; 24: 160–166.
[14]	Blacklock C, MacPepple E, Kunutsor S, et al. Paying for Performance to Improve the Delivery and Uptake of Family Planning in Low and Middle Income Countries: A Systematic Review. Stud Fam Plann 2016; 47: 309–324.
[15]	Donabedian A. Evaluating the Quality of Medical Care. Milbank Q 2005; 83: 691–729.

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Agonnoude Togbédji Maurice, Houeto Sègbegnon David, Sambieni N’koué Emmanuel, Adoukonou Tododjitché Thierry Armel. (2020). Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin. Central African Journal of Public Health, 6(5), 293-298. https://doi.org/10.11648/j.cajph.20200605.18

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Agonnoude Togbédji Maurice; Houeto Sègbegnon David; Sambieni N’koué Emmanuel; Adoukonou Tododjitché Thierry Armel. Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin. Cent. Afr. J. Public Health 2020, 6(5), 293-298. doi: 10.11648/j.cajph.20200605.18

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AMA Style

Agonnoude Togbédji Maurice, Houeto Sègbegnon David, Sambieni N’koué Emmanuel, Adoukonou Tododjitché Thierry Armel. Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin. Cent Afr J Public Health. 2020;6(5):293-298. doi: 10.11648/j.cajph.20200605.18

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@article{10.11648/j.cajph.20200605.18,
  author = {Agonnoude Togbédji Maurice and Houeto Sègbegnon David and Sambieni N’koué Emmanuel and Adoukonou Tododjitché Thierry Armel},
  title = {Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin},
  journal = {Central African Journal of Public Health},
  volume = {6},
  number = {5},
  pages = {293-298},
  doi = {10.11648/j.cajph.20200605.18},
  url = {https://doi.org/10.11648/j.cajph.20200605.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20200605.18},
  abstract = {Background: two pilot studies of RBF have been conducted in some health districts of Benin since 2012, which results have been scaled up in 2015. Then, it’s important to see whether the impacts of health care from those studies will be confirmed by HFs performance in IS. Objective: to analyze the impact of RBF on IS performance in Parakou/N’dali and Nikki/Kalalé/Pèrèrè health districts, through the quality of the structure and the process of supplying these services, and their possible association with the immunization services performance. Method: A retrospective study was conducted including all public and private functional HFs covered by the period of 14 trimesters (T1 2014 to T2 2017). The dependent variable was the performance in IS. The independent variables were the quality of the structure, the quality of the process and the environment. A linear regression model was adjusted; the significance threshold was 5%. Results: 55 HFs participated to the study; they were mostly in rural areas (76.4%) and 36.4% were at the first level of the pyramid. There was no improvement in both trained staff (p=0.67) and midwifery staff (p=0.75) and in the rest of the structure (p=0.697); however there was a significant improvement in supplying process of immunization services (p=0.001) and the performance in IS (p=0.010). In multivariate analysis, overall and in cluster by area analysis, models were not significant. Conclusion: RBF act only on the processes of supplying immunization services to improve HF performance, taking into account the environment. No explained factors were found for this performance improvement. Local dynamics in each HF should be in action which can be uncover in interactions with local actors.},
 year = {2020}
}

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TY - JOUR
T1 - Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin
AU - Agonnoude Togbédji Maurice
AU - Houeto Sègbegnon David
AU - Sambieni N’koué Emmanuel
AU - Adoukonou Tododjitché Thierry Armel
Y1 - 2020/10/07
PY - 2020
N1 - https://doi.org/10.11648/j.cajph.20200605.18
DO - 10.11648/j.cajph.20200605.18
T2 - Central African Journal of Public Health
JF - Central African Journal of Public Health
JO - Central African Journal of Public Health
SP - 293
EP - 298
PB - Science Publishing Group
SN - 2575-5781
UR - https://doi.org/10.11648/j.cajph.20200605.18
AB - Background: two pilot studies of RBF have been conducted in some health districts of Benin since 2012, which results have been scaled up in 2015. Then, it’s important to see whether the impacts of health care from those studies will be confirmed by HFs performance in IS. Objective: to analyze the impact of RBF on IS performance in Parakou/N’dali and Nikki/Kalalé/Pèrèrè health districts, through the quality of the structure and the process of supplying these services, and their possible association with the immunization services performance. Method: A retrospective study was conducted including all public and private functional HFs covered by the period of 14 trimesters (T1 2014 to T2 2017). The dependent variable was the performance in IS. The independent variables were the quality of the structure, the quality of the process and the environment. A linear regression model was adjusted; the significance threshold was 5%. Results: 55 HFs participated to the study; they were mostly in rural areas (76.4%) and 36.4% were at the first level of the pyramid. There was no improvement in both trained staff (p=0.67) and midwifery staff (p=0.75) and in the rest of the structure (p=0.697); however there was a significant improvement in supplying process of immunization services (p=0.001) and the performance in IS (p=0.010). In multivariate analysis, overall and in cluster by area analysis, models were not significant. Conclusion: RBF act only on the processes of supplying immunization services to improve HF performance, taking into account the environment. No explained factors were found for this performance improvement. Local dynamics in each HF should be in action which can be uncover in interactions with local actors.
VL - 6
IS - 5
ER -

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Author Information

Agonnoude Togbédji Maurice

National School of Epidemiology and Public Health (éNATSE), University of Parakou, Parakou, Benin
Houeto Sègbegnon David

National School of Epidemiology and Public Health (éNATSE), University of Parakou, Parakou, Benin
Sambieni N’koué Emmanuel

Letters, Arts and Human Sciences Faculty (FLASH), University of Parakou, Parakou, Benin
Adoukonou Tododjitché Thierry Armel

National School of Epidemiology and Public Health (éNATSE), University of Parakou, Parakou, Benin

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Agonnoude Togbédji Maurice, Houeto Sègbegnon David, Sambieni N’koué Emmanuel, Adoukonou Tododjitché Thierry Armel. (2020). Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin. Central African Journal of Public Health, 6(5), 293-298. https://doi.org/10.11648/j.cajph.20200605.18

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Agonnoude Togbédji Maurice; Houeto Sègbegnon David; Sambieni N’koué Emmanuel; Adoukonou Tododjitché Thierry Armel. Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin. Cent. Afr. J. Public Health 2020, 6(5), 293-298. doi: 10.11648/j.cajph.20200605.18

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AMA Style

Agonnoude Togbédji Maurice, Houeto Sègbegnon David, Sambieni N’koué Emmanuel, Adoukonou Tododjitché Thierry Armel. Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin. Cent Afr J Public Health. 2020;6(5):293-298. doi: 10.11648/j.cajph.20200605.18

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@article{10.11648/j.cajph.20200605.18,
  author = {Agonnoude Togbédji Maurice and Houeto Sègbegnon David and Sambieni N’koué Emmanuel and Adoukonou Tododjitché Thierry Armel},
  title = {Impact of Performance Based Financing on Health Facilities Performance in Immunization in Two Health Districts in Benin},
  journal = {Central African Journal of Public Health},
  volume = {6},
  number = {5},
  pages = {293-298},
  doi = {10.11648/j.cajph.20200605.18},
  url = {https://doi.org/10.11648/j.cajph.20200605.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20200605.18},
  abstract = {Background: two pilot studies of RBF have been conducted in some health districts of Benin since 2012, which results have been scaled up in 2015. Then, it’s important to see whether the impacts of health care from those studies will be confirmed by HFs performance in IS. Objective: to analyze the impact of RBF on IS performance in Parakou/N’dali and Nikki/Kalalé/Pèrèrè health districts, through the quality of the structure and the process of supplying these services, and their possible association with the immunization services performance. Method: A retrospective study was conducted including all public and private functional HFs covered by the period of 14 trimesters (T1 2014 to T2 2017). The dependent variable was the performance in IS. The independent variables were the quality of the structure, the quality of the process and the environment. A linear regression model was adjusted; the significance threshold was 5%. Results: 55 HFs participated to the study; they were mostly in rural areas (76.4%) and 36.4% were at the first level of the pyramid. There was no improvement in both trained staff (p=0.67) and midwifery staff (p=0.75) and in the rest of the structure (p=0.697); however there was a significant improvement in supplying process of immunization services (p=0.001) and the performance in IS (p=0.010). In multivariate analysis, overall and in cluster by area analysis, models were not significant. Conclusion: RBF act only on the processes of supplying immunization services to improve HF performance, taking into account the environment. No explained factors were found for this performance improvement. Local dynamics in each HF should be in action which can be uncover in interactions with local actors.},
 year = {2020}
}

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