Analysis of social investment in health systems reform: a case study of results-based financing in Marondera District, Zimbabwe.
Pan Afr Med J
; 49: 4, 2024.
Article
em En
| MEDLINE
| ID: mdl-39372695
ABSTRACT
Introduction:
suboptimal use of donor funds and poor health systems performance is rife across most developing countries; to address this, results-based financing (RBF) models were developed. However, it is imperative to explore the emic and context specific influence of results-based financing in health systems performance. This study therefore sought to explore the influence of results-based financing on health worker motivation and governance, temporal perspective, distributional principle, and policy coherence. Finally, the influence of results-based financing on interrelations across donors, technical partners, and health workers was explored.Methods:
the study adopted a qualitative, exploratory, descriptive, phenomenological design using audio-recorded face-to-face semi-structured interviews to capture diverse perspectives from the remaining and available two health financing experts, two technical partner organization representatives, and six health workers who have been implementing results-based financing from 2011 to 2022 in the Marondera district of Zimbabwe. Data was transcribed and collectively analyzed using NVIVO software.Results:
improved staff motivation, better governance, health system development, equity, and policy consistency were attributable to results-based financing, notwithstanding several challenges including understaffing, increased workload, procurement red tape, financial rigidity, and delays in subsidy payments, which eroded gains of better performance. Additionally, a lack of continuum of care due to user fees faced by the poor at higher levels of care, and limited engagement between donors and healthcare facility workers were also observed.Conclusion:
reinforcing pinpointed positives is vital for sustaining realized health gains; however, urgent attention is required to address the challenges to safeguard the milestones achieved thus far.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Entrevistas como Assunto
/
Pessoal de Saúde
/
Reforma dos Serviços de Saúde
/
Atenção à Saúde
/
Financiamento da Assistência à Saúde
Limite:
Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
Pan Afr Med J
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
África do Sul
País de publicação:
Uganda