Evaluating complex health financing interventions: Using mixed methods to inform further implementation of a novel PBI intervention in rural Malawi

BMC Health Services Research

Volumn 16, Issue 1, 2016, Pages

  McMahon, Shannon A ^a   Brenner, Stephan ^a   Lohmann, Julia ^a   Makwero, Christopher ^b   Torbica, Aleksandra ^c   Mathanga, Don P ^b   Muula, Adamson S ^b   De Allegri, Manuela ^a  

^a UNIVERSITY OF HEIDELBERG   (Germany)

^b UNIVERSITY OF MALAWI   (Malawi)

^c BOCCONI UNIVERSITY   (Italy)

Author keywords

Health financing; Malawi; Performance based financing; Performance based incentives; Process evaluation; Research protocol; Results based financing

Indexed keywords

COST BENEFIT ANALYSIS; ECONOMICS; HEALTH CARE FINANCING; HEALTH CARE PERSONNEL; HEALTH CARE QUALITY; HUMAN; MALAWI; METHODOLOGY; MOTIVATION; PROSPECTIVE STUDY; PSYCHOLOGY; REIMBURSEMENT; RURAL HEALTH CARE; SALARY AND FRINGE BENEFIT;

COST-BENEFIT ANALYSIS; HEALTH PERSONNEL; HEALTHCARE FINANCING; HUMANS; MALAWI; MOTIVATION; PROSPECTIVE STUDIES; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE; RESEARCH DESIGN; RURAL HEALTH SERVICES; SALARIES AND FRINGE BENEFITS;

EID: 84982244986     PISSN: None     EISSN: 14726963     Source Type: Journal    
DOI: 10.1186/s12913-016-1612-2     Document Type: Article

References (41)

1. Fritsche GB, Soeters R, Meessen B. Performance-based financing toolkit: world bank publications. 2014.
2. Musgrove P. Financial and other rewards for good performance or results, a guided tour of concepts and terms and a short glossary. Washington: World Bank; 2011. p. 1-12.
3. Eichler R, Agarwal K, Askew I, Iriarte E, Morgan L, Watson J. Performance-based incentives to improve health status of mothers and newborns: what does the evidence show? Journal of health, population, and nutrition. 2013;31(4 Suppl 2):S36.
4. Witter S, Fretheim A, Kessy FL, Lindahl AK. Paying for performance to improve the delivery of health interventions in low-and middle-income countries. Cochrane Database Syst Rev. 2012;2(2):CD007899.
5. Gergen J, Josephson E, Coe M, Ski S, Madhavan S, Bauhoffe S. How do performance-based financing programs incorporate quality of care? An overview of 32 programs in 29 countries. [Draft Manuscript]. In press 2016.
6. Basinga P, Gertler PJ, Binagwaho A, Soucat AL, Sturdy J, Vermeersch CM. Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation. Lancet. 2011;377(9775):1421-8.
7. Rusa L, Ngirabega JD, Janssen W, Van Bastelaere S, Porignon D, Vandenbulcke W. Performance-based financing for better quality of services in Rwandan health centres: 3-year experience. Tropical Medicine & International Health. 2009;14(7):830-7.
8. Soeters R, Peerenboom PB, Mushagalusa P, Kimanuka C. Performance-based financing experiment improved health care in the Democratic Republic of Congo. Health Aff. 2011;30(8):1518-27.
9. Meessen B, Soucat A, Sekabaraga C. Performance-based financing: just a donor fad or a catalyst towards comprehensive health-care reform? Bull World Health Organ. 2011;89(2):153-6.
10. Ireland M, Paul E, Dujardin B. Can performance-based financing be used to reform health systems in developing countries? Bull World Health Organ. 2011;89(9):695-8.
11. Frey BS, Jegen R. Motivation crowding theory: a survey of empirical evidence. Institute for Empirical Research in Economics, University of Zurich;1999.
12. Kalk A, Paul FA, Grabosch E. 'Paying for performance'in Rwanda: does it pay off? Trop Med Int Health. 2010;15(2):182-90.
13. Kalk A. The costs of performance-based financing. Bull World Health Organ. 2011;89(5):319.
14. Fretheim A, Witter S, Lindahl AK, Olsen IT. Performance-based financing in low-and middle-income countries: still more questions than answers. Bull World Health Organ. 2012;90(8):559-A.
15. Gorter AC, Ir M, Meessen B. Evidence Review, Results-Based Financing of Maternal and Newborn Health Care in Low-and Lower-Middle-Income Countries. 2013.
16. Borghi J, Little R, Binyaruka P, Patouillard E, Kuwawenaruwa A. In Tanzania, The Many Costs Of Pay-For-Performance Leave Open To Debate Whether The Strategy Is Cost-Effective. Health Aff. 2015;34(3):406-14.
17. Malawi Go. Performance Based Incentives - Operational Manual. In: Malawi MoH, editor. Lilongwe: USAID and SSDI; 2014. p. 61.
18. National Statistics Office (Malawi) IM. Malawi Demographic and Health Survey 2010. Zomba, Malawi, and Calverton, MD, USA: 2010.
19. Malawi UN. Millennium Development Goals online: United Nations [cited 2015 December 18]. 2015. Available from: http://www.mw.one.un.org/millennium-development-goals/.
20. Ministry of Health Malawi II. Malawi Service Provision Assessment (MSPA) 2013-14. Lilongwe, Malawi, and Rockville, MD, USA: 2013-2014.
21. Kumbani L, Bjune G, Chirwa E, Odland JØ. Why some women fail to give birth at health facilities: a qualitative study of women's perceptions of perinatal care from rural Southern Malawi. Reprod Health. 2013;10(1):9.
22. Parkhurst JO, Penn-Kekana L, Blaauw D, Balabanova D, Danishevski K, Rahman SA, et al. Health systems factors influencing maternal health services: a four-country comparison. Health Policy. 2005;73(2):127-38.
23. Ministry of Health Malawi II. Malawi Health Sector Strategic Plan 2011-2016. Lilongwe, Malawi: 2012
24. Abiiro GA, Mbera GB, De Allegri M. Gaps in universal health coverage in Malawi: A qualitative study in rural communities. BMC Health Serv Res. 2014;14(1):234.
25. Bowie C, Mwase T. Assessing the use of an essential health package in a sector wide approach in Malawi. Health Research Policy and Systems. 2011;9(1):1.
26. Mueller DH, Lungu D, Acharya A, Palmer N. Constraints to implementing the essential health package in Malawi. PLoS One. 2011;6(6):e20741.
27. Wang Q, Brenner S, Leppert G, Banda TH, Kalmus O, De Allegri M. Health seeking behaviour and the related household out-of-pocket expenditure for chronic non-communicable diseases in rural Malawi. Health Policy Plan. 2015;30(2):242-52.
28. Brenner S, Muula AS, Robyn PJ, Bärnighausen T, Sarker M, Mathanga DP, et al. Design of an impact evaluation using a mixed methods model-an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi. BMC Health Serv Res. 2014;14(1):180.
29. Senlet P, Kachiza C, Katekaine J, Peters J. USAID/Malawi Support for Service Delivery-Integration performance evaluation. Lilongwe, Malawi, and Vienna. Virginia: IBTCI; 2014.
30. Rawlins BJ, Kim Y-M, Rozario AM, Bazant E, Rashidi T, Bandazi SN, et al. Reproductive health services in Malawi: an evaluation of a quality improvement intervention. Midwifery. 2013;29(1):53-9.
31. Witter S, Toonen J, Meessen B, Kagubare J, Fritsche G, Vaughan K. Performance-based financing as a health system reform: mapping the key dimensions for monitoring and evaluation. BMC Health Serv Res. 2013;13(1):367.
32. Renmans D, Holvoet N, Orach CG, Criel B. Opening the 'black box'of performance-based financing in low-and lower middle-income countries: a review of the literature. Health Policy and Planning. 2016:czw045.
33. Bandura A. Social foundations of thought and action: a social cognitive theory: prentice-hall, Inc. 1986.
34. Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S. A conceptual framework for implementation fidelity. Implement Sci. 2007;2(1):40.
35. Hasson H, Blomberg S, Dunér A. Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care. Implement Sci. 2012;7(23):1-11.
36. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions. Med Res Council Guid bmj. 2015;350:h1258.
37. Kalolo A, Radermacher R, Stoermer M, Meshack M, De Allegri M. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region. Global Health Action. 2015;8.
38. Ridde V, Turcotte-Tremblay A-M, Souares A, Lohmann J, Zombré D, Koulidiati JL, et al. Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso. Implement Sci. 2014;9(1):149.
39. Boyatzis RE. Transforming qualitative information: thematic analysis and code development: sage. 1998.
40. Crabtree BF, Miller WL. Doing qualitative research: sage publications. 1999.
41. Alliance for Health Policy and Systems Research, USAID, World Bank, USAID TRAction, Johns Hopkins and URC. Statement on Advancing Implementation Research and Delivery Science in Cape Town, South Africa (cited 2016 May 12). 2014. Available from: http://www.healthsystemsglobal.org/the-irds-statement/.