ArticleThe Pan African medical journal2025
Impact of performance-based financing on maternal and child health outcomes at the subnational level in the Central African Republic.
Article in The Pan African medical journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: maternal and child health remains a major challenge in the Central African Republic (CAR), with alarming indicators worsened by recurrent crises. This study aims to assess the impact of performance-based financing (PBF), implemented as part of the Health System Support Project (PASS), on maternal and child health indicators in the Kémo health district between 2019 and 2020. The study aims to assess the impact of PBF on maternal and child health indicators. Methods: this retrospective cross-sectional study with a before/after comparison was conducted in June 2024 in 14 health facilities in the sub-prefectures of Dekoa and Mala (Kémo health district, CAR), which had implemented performance-based financing between 2019 and 2020. Convenience sampling was used. The analysis was carried out using Excel and Epi-info version 7.2.6. Results: the study revealed that the number of skilled personnel almost doubled in all professional categories after the introduction of PBF. A significant improvement in medical equipment and health infrastructure was noted. Coverage of delivery assisted by skilled personnel increased from 64.76% before to 71.95% after, OR = 1.39; 95% CI = [1.27-1]. Coverage of ANC4+ antenatal consultation increased from 58.90% before to 93.58% after, OR= 10.17 95% CI= [9.55-10.84]. Coverage of Penta 3 vaccine increased from 48.30% before to 79.57% after, OR = 4.17; 95% CI= [3.18-4.48]. All these results were significant, with p < 0.05. Conclusion: performance-based financing has improved maternal and child health indicators in the district. As for its effect on improving the quality of maternal and child health care, other factors need to be taken into account, which will require further study.
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