Effects of results based financing models on the performance of exposed health zones in Benin

Authors

  • Lamidhi Salami Department of Policy and Health System, Regional Institute of Public Health, University of Abomey-Calavi, Benin http://orcid.org/0000-0002-3261-3173
  • Edgard-Marius Ouendo Department of Policy and Health System, Regional Institute of Public Health, University of Abomey-Calavi, Benin
  • Benjamin Fayomi Department of Public Health, Faculty of Health Sciences, University of Abomey-Calavi, Benin

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20183953

Keywords:

Performance, Financing, Health system, Benin, Mortality, Results based financing

Abstract

Background: Since 2011, Benin adhered to results-based financing (RBF), with the implementation of RBF_PRPSS model by Health System Performance Strengthening Project (PRPSS) and RBF_PASS model by health system support project (PASS). Notwithstanding the lack of evidence on this experimental phase, the Ministry of Health initiated the extension of the RBF_PRPSS model to uncovered areas. This comparative study was led to evaluate the health system performance in RBF zones.

Methods: The study examined data from sixty-seven health facilities in six health zones offering maternal and child health services, using the double difference, the Student's test and the variance comparison, with 5% significance level.

Results: The study found that between 2011 and 2014, staff numbers remained stable in the RBF strata (p>0.05). The cumulative duration over a six-month period of stock-outs of five key drugs (paracetamol, amoxicillin, oxytocin, iron, sulfadoxine pyrimetamine) decreased from 51 days to 29 days (p<0.05). Direct revenues per health facility increased more in the RBF strata (p<0.05). Financial viability increased in RBF_PRPSS stratum. Health services utilization improved significantly for institutional delivery, tetanus toxoid immunization, DTP (Hib) HepB 3 and MCV immunization and curative care. Decreasing of maternal and neonatal mortalities in RBF strata were not significant.

Conclusions: In sum, the RBF implementation has not yet generated a significant effect on the overall performance of the health system in exposed areas, although it is already accompanied by a significant improvement in the utilization of certain health care services.

 

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Published

2018-09-24

How to Cite

Salami, L., Ouendo, E.-M., & Fayomi, B. (2018). Effects of results based financing models on the performance of exposed health zones in Benin. International Journal Of Community Medicine And Public Health, 5(10), 4188–4199. https://doi.org/10.18203/2394-6040.ijcmph20183953

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Section

Original Research Articles