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Abstract
Background
In recent years, Performance Based Financing (PBF); a form of result based financing, has
attracted a global attention in health systems in developing countries. PBF promotes
autonomous health facilities, motivates and introduces financial incentives to motivate health
facilities and health workers to attain pre-determined targets. To achieve this, The Tanzanian
government through the Christian Social Services Commission initiated a PBF pilot project in
Rungwe district, Mbeya region. Kilimanjaro Christian Medical Center was given the role of
training health workers on PBF principles in Rungwe. The aim of this study was to explore
health care providers’ perception on a three years training on PBF principles in a PBF pilot
project at Rungwe District in Mbeya, Tanzania.
Methods
This was an explorative qualitative study, which took place at Rungwe PBF pilot area in
October 2012. Twenty six (26) participants were purposively selected.
Six took part in- depthinterviews (IDIs) and twenty (20) in the group discussions. Both the IDIs and the GDs
explored the perceived benefit and challenges of implementing PBF in their workplace. Data
were manually analyzed using content analysis approach.
Results
Overall informants had positive perspectives on PBF training. Most of the health facilities
were able to implement some of the PBF concepts in their work places after the training, such
as developing job descriptions for their staff, creating quarterly business plans for their
facilities, costing for their services and entering service agreement with the government,
improved record keeping, customer care and involving community as partners in running
their facilities. The most common principle of paying individual performance bonuses was
mentioned as a major challenge due to inadequate funding and poor design of Rungwe PBF
pilot project.
Conclusion
Despite poor design and inadequate funding, our findings have shown some promising results
after PBF training in the study area. The findings have highlighted the potential of PBF to act
as leverage for initiating innovative and proactive actions, which may motivate health
personnel performance and quality of care in the study setting with minimal support.
However, key policy issues at the national level should be addressed in order to exploit this
opportunity.
Keywords
Performance Based Financing, PBF pilot project, Rungwe, Tanzania |
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