ArticleGlobalization and health2017
Setting performance-based financing in the health sector agenda: a case study in Cameroon.
Article in Globalization and health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Health economics in Africa: historical perspectives, current challenges, and policy recommendations for sustainable healthcare financing and resource allocation.Cost effectiveness and resource allocation : C/E · 2026Review
- How policy entrepreneurs solve local health problems in the global South: an exploratory study.Health policy and planning · 2025Article
- Towards institutionalizing HTA in Ethiopia: using a political economy analysis to explore stakeholder perspectives and assessing capacity needs.International journal of technology assessment in health care · 2025Article
- Political Prioritisation for Performance-Based Financing at the County Level in Kenya: 2015 to 2018.International journal of health policy and management · 2023Article
- Development of Monitoring and Evaluation Systems in Four National Programs Addressing Mother and Child Health in Cote d'Ivoire: Qualitative Analysis of the Emergence and Formulation Process.Risk management and healthcare policy · 2023Article
- Beyond political will: unpacking the drivers of (non) health reforms in sub-Saharan Africa.BMJ global health · 2022Review
- Article
- Is Performance-Based Financing A Pathway to Strategic Purchasing in Sub-Saharan Africa? A Synthesis of the Evidence.Health systems and reform · 2022Review
- Power analysis in health policy and systems research: a guide to research conceptualisation.BMJ global health · 2021Article
- Transnational Networks' Contribution to Health Policy Diffusion: A Mixed Method Study of the PerformanceBased Financing Community of Practice in Africa.International journal of health policy and management · 2021Article
- Political economy analysis of the performance-based financing programme in Afghanistan.Global health research and policy · 2021Article
- From administrative hospital management to performancebased management: Paradigm shift at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital, Cameroon.Journal of public health in Africa · 2020Article
- The hepatitis C infection in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams framework.Health research policy and systems · 2019Article
- Coming Full Circle: How Health Worker Motivation and Performance in Results-Based Financing Arrangements Hinges on Strong and Adaptive Health Systems.International journal of health policy and management · 2019Article
- How is the discourse of performance-based financing shaped at the global level? A poststructural analysis.Globalization and health · 2019Article
- Ownership of health financing policies in low-income countries: a journey with more than one pathway.BMJ global health · 2019Article
- The political economy of results-based financing: the experience of the health system in Zimbabwe.Global health research and policy · 2019Article
- The bumpy trajectory of performance-based financing for healthcare in Sierra Leone: agency, structure and frames shaping the policy process.Globalization and health · 2018Article
- Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon.BMJ global health · 2018Article
- Towards constructive rethinking of PBF: perspectives of implementers in sub-Saharan Africa.BMJ global health · 2018Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMore than 30 countries in sub-Saharan Africa have introduced performance-based financing (PBF) in their healthcare systems. Yet, there has been little research on the process by which PBF was put on the national policy agenda in Africa. This study examines the policy process behind the introduction of PBF program in Cameroon.
methodsThe research is an explanatory case study using the Kingdon multiple streams framework. We conducted a document review and 25 interviews with various types of actors involved in the policy process. We conducted thematic analysis using a hybrid deductive-inductive approach for data analysis.
resultsBy 2004, several reports and events had provided evidence on the state of the poor health outcomes and health financing in the country, thereby raising awareness of the situation. As a result, decision-makers identified the lack of a suitable health financing policy as an important issue that needed to be addressed. The change in the political discourse toward more accountability made room to test new mechanisms. A group of policy entrepreneurs from the World Bank, through numerous forms of influence (financial, ideational, network and knowledge-based) and building on several ongoing reforms, collaborated with senior government officials to place the PBF program on the agenda. The policy changes occurred as the result of two open policy windows (i.e. national and international), and in both instances, policy entrepreneurs were able to couple the policy streams to effect change.
conclusionThe policy agenda of PBF in Cameroon underlined the importance of a perceived crisis in the policy reform process and the advantage of building a team to carry forward the policy process. It also highlighted the role of other sources of information alongside scientific evidence (eg.: workshop and study tour), as well as the role of previous policies and experiences, in shaping or influencing respectively the way issues are framed and reformers' actions and choices.
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