Evaluation of performance based financing practices among health workers in Nigeria

Abstract

Performance Based Financing (PBF) is an approach to health financing that shifts attention from inputs to outputs, and eventually to the outcomes of health services. The study evaluated the health workers’ knowledge, attitude, practice, quality of health care, motivation, infrastructural development as well as addressing the shortage of health work force. A descriptive cross sectional study was conducted among 315 health workers in Nigeria. The majority of the respondents demonstrated good knowledge, however, there was a statistically significant difference in the knowledge of the respondents in the primary health facilities in terms of their age groups. More than half of the respondents agreed strongly that PBF makes them more proactive in carrying out their daily duties with patient’s satisfaction. Qualitative analysis showed that the carrot-stick approach in PBF was a real motivator, the carrot was the bonus (incentives) given or withholding to the health workers for good or poor quality service provided. Most of health workers stayed later than closing time to ensure the health services are provided. On infrastructural development, well-constructed and maintained incinerator for waste disposal and running water were installed at all of the health facilities among many other infrastructures. Also, more health workers were employed including laboratory technicians.