Universität zu Köln

Rudasingwa, Martin, Soeters, Robert and Basenya, Olivier (2017). The effect of performance-based financing on maternal healthcare use in Burundi: a two-wave pooled cross-sectional analysis. Glob. Health Action, 10. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1654-9880

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Abstract

Background: Several developing countries, especially in Africa, have implemented performance-based financing (PBF) schemes with the aim of improving healthcare provision. PBF was first implemented in Burundi in 2006 as a pilot programme in three provinces and was rolled out nationwide in 2010. Objective: To enrich existing studies on Burundi in three ways. Firstly, by evaluating the effect of PBF on maternal care at primary and hospital levels; secondly, on the possession of maternity logbooks for maternal care records; and thirdly, how the amount of subsidies influences healthcare outputs. Design: We used data from repeated cross-sectional surveys in 500 households (intervention group: 225; control group: 275) conducted in 2006 and 2008. A total of 274 women, aged 1549, who had recently given birth, were interviewed about the use of maternal healthcare and the possession of maternity logbooks. We performed a difference-in-differences analysis using pooled cross-sectional survey data from 2006 and 2008. Results: We found that PBF is associated with an increased institutional deliveries probability of 39.5 percentage points (p < 0.01) - a relative improvement of 81.8%. Institutional deliveries probability increased significantly only at health centre level by 33.6 percentage points (p < 0.01), a relative rise of 80.6%. There is an indication of a positive spillover effect of PBF on the possession of maternity logbooks. We found no PBF effect on the number of antenatal care visits and anti-tetanus immunization. Conclusions: Our findings suggest that institutional delivery highly improved because it came from a low baseline and its unit payment was relatively high, leading health workers to promote its use. The fact that deliveries mainly increased in health centres and not in hospitals may be explained by the context of how health delivery is organized in Burundi. Health policymakers have to determine the appropriate financial incentives that best influence the improvement of each health service.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rudasingwa, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Soeters, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Basenya, Olivier UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-227620
DOI:	10.1080/16549716.2017.1327241
Journal or Publication Title:	Glob. Health Action
Volume:	10
Date:	2017
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1654-9880
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SERVICES; ACHIEVE; WORKERS; IMPACT Multiple languages Public, Environmental & Occupational Health Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/22762