Impact du Financement Basé sur les Résultats sur la Performance en Accouchement des Formations Sanitaires des Zones Sanitaires Parakou N’Dali et Nikki Kalalé Pèrèrè : Impact of results-based financing on health facilities performance in institutional delivery: a study of two health districts of North Benin.

Abstract

Background. Two pilot studies of RBF have been conducted in some health districts of Benin since 2012, which results have been scaled up in 2015. Then, it’s important to see whether the impacts of health care from those studies will be confirmed by HFs performance in ID. Objective. To analyze the impact of RBF on ID performance in Parakou/N’dali and Nikki/Kalalé/Pèrèrè health district, through the quality of the structure and the process of supplying these services, and their possible association with the institutional delivery’s performance. Method. A retrospective study was conducted including all public and private functional HFs covered by the period of 14 quarters (Q1 2014 to Q2 2017). The dependent variable was the performance. The independent variables were the quality of the structure, the quality of the process and the environment. A linear regression model was adjusted; the significance threshold was 5%. Results. 55 HFs participated to the study; they were mostly in rural areas (76.4%) and 36.4% were at the first level of the pyramid. There was no improvement in the structure (p=0.761), in both trained staff (p=0.67) and midwifery staff (p=0.75), nor in the performance in ID (p=0.527); however there was a significant improvement in the supplying process of ID services (p=0.001). Conclusion. RBF should act not only on the processes of supplying services, but also on the structures, taking into account the environment.