Impact of Performance-Based Financing on The Standards of Care-Delivery Rendered to Consumers in The Kumba Health District, SouthWest Region; Cameroon

Abstract

In recent years, Performance-Based Financing (PBF); a form of result based financing, has attracted global attention in health systems in developing countries. PBF promotes autonomous health facilities, motivates and introduces financial incentives to motivate health facilities and Health-Care Providers to attain pre-determined targets. This study was aimed at assessing the impact of Performance-Based Financing in the standards of care delivery rendered to consumers in the Kumba Health District, Southwestern Cameroon. A hospital and community based comparative and cross-sectional research design were used for this study. Data were collected in 9 randomly selected health facilities and in the catchment areas of the selected health facilities. Data were collected using structured questionnaires and analyzed using SPSS statistics 21 and were considered significant at P ≤ 0.05. Results revealed that Health-Care Providers in Kumba Health District have a good level of knowledge on PBF and PBF services and also good motivation. Respondents in confessional health facilities were 3.5 times (OR=3.58, 95% CI: 1.53- 8.42, P=0.003) more motivated compared public facilities. Respondents in private were 1.8 times (OR=1.82, 95% CI: 0.264-1.78, P>0.05) more motivated compared to confessional facilities. And conversely, public services were 4.2 times (OR=4.18, 95% CI: 1.53- 8.42, P=0.003) more affordable than private. Confessional services were 2.1 times (OR=2.11, 95% CI: 0.264-1.78, P>0.05) more affordable compared to private services. The findings reveal a good implementation of PBF in the Kumba Health District despite the poor sharing of information in some health facilities and the low level of implementation of household visits.