ArticleInternational journal of health policy and management2019
The Importance of Leadership and Organizational Capacity in Shaping Health Workers' Motivational Reactions to Performance-Based Financing: A Multiple Case Study in Burkina Faso.
Article in International journal of health policy and management, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Understanding the municipal-level design and adaptation of pay-for-performance schemes across two states of Brazil.Health policy and planning · 2024Article
- How personnel diversity and affective bonds affect performance-based financing: a moderator analysis of a difference-in-difference estimator.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Article
- Is Performance-Based Financing A Pathway to Strategic Purchasing in Sub-Saharan Africa? A Synthesis of the Evidence.Health systems and reform · 2022Review
- Using Information and Communication Technologies to Engage Citizens in Health System Governance in Burkina Faso: Protocol for Action Research.JMIR research protocols · 2021Article
- "It Depends on What They Experience in Each Health Facility. Some Are Satisfied, Others Are Not." A MixedMethods Exploration of Health Workers' Attitudes Towards Performance-Based Financing in Burkina Faso.International journal of health policy and management · 2021Article
- Does the gap between health workers' expectations and the realities of implementing a performance-based financing project in Mali create frustration?Global health research and policy · 2021Article
- An Empirical Study on Talent Management Strategies of Knowledge-Based Organizations Using Entrepreneurial Psychology and Key Competence.Frontiers in psychology · 2021Article
- Implementing performance-based financing in peripheral health centres in Mali: what can we learn from it?Health research policy and systems · 2020Article
- Meeting the challenges posed by per diem in development projects in southern countries: a scoping review.Globalization and health · 2020Article
- Analysis of the implementation of a community-based intervention to control dengue fever in Burkina Faso.Implementation science : IS · 2020Article
- Unravelling the role of leadership in motivation of health workers in a Moroccan public hospital: a realist evaluation.BMJ open · 2020Article
- Does public service motivation matter in Moroccan public hospitals? A multiple embedded case study.International journal for equity in health · 2019Article
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Authors and funding
5 authors.
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Abstract
backgroundPerformance-based financing (PBF) is currently tested in many low- and middle-income countries as a health system strengthening strategy. One of the main mechanisms through which PBF is assumed to effect change is by motivating health workers to improve their service delivery performance. This article aims at a better understanding of such motivational effects of PBF. In particular, the study focused on organizational context factors and health workers' perceptions thereof as moderators of the motivational effects of PBF, which to date has been little explored.
methodsWe conducted a multiple case study in 2 district hospitals and 16 primary health facilities across three districts. Health facilities were purposely sampled according to pre-PBF performance levels. Within sampled facilities, 82 clinical skilled healthcare workers were in-depth interviewed one year after the start of the PBF intervention. Data were analyzed using a blended deductive and inductive process, using self-determination theory (SDT) as an analytical framework.
resultsResults show that the extent to which PBF contributed to positive, sustainable forms of motivation depended on the "ground upon which PBF fell," beyond health workers' individual personalities and disposition. In particular, health workers described three aspects of the organizational context in which PBF was implemented: the extent to which existing hierarchies fostered as opposed to hindered participation and transparency; managers' handling of the increased performance feedback inherent in PBF; and facility's pre-PBF levels in regards to infrastructure, equipment, and human resources.
conclusionOur results underline the importance of leadership styles and pre-implementation performance levels in shaping health workers' motivational reactions to PBF. Ancillary interventions aimed at fostering participatory as opposed to directional leadership or start-up support to low-performing health facilities will likely boost PBF effects in regards to the development of valuable motivational capacities.
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