@article{fdi:010075544,
  title = {{T}he importance of leadership and organizational capacity in shaping health workers' motivational reactions to performance-based financing : a multiple case study in {B}urkina {F}aso},
  author = {{F}illol, {A}. and {L}ohmann, {J}. and {T}urcotte-{T}remblay, {A}. {M}. and {S}ome, {P}. {A}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {P}erformance-based financing ({PBF}) is currently tested in many low- and middle-income countries as a health system strengthening strategy. {O}ne of the main mechanisms through which {PBF} is assumed to effect change is by motivating health workers to improve their service delivery performance. {T}his article aims at a better understanding of such motivational effects of {PBF}. {I}n 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. {M}ethods: {W}e conducted a multiple case study in 2 district hospitals and 16 primary health facilities across three districts. {H}ealth facilities were purposely sampled according to pre-{PBF} performance levels. {W}ithin sampled facilities, 82 clinical skilled healthcare workers were in-depth interviewed one year after the start of the {PBF} intervention. {D}ata were analyzed using a blended deductive and inductive process, using self-determination theory ({SDT}) as an analytical framework. {R}esults: {R}esults 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. {I}n 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. {C}onclusion: {O}ur results underline the importance of leadership styles and pre-implementation performance levels in shaping health workers' motivational reactions to {PBF}. {A}ncillary 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.},
  keywords = {{M}otivation ; {O}rganizational {C}ontext ; {P}erformance-{B}ased {F}inancing ({PBF}) ; {Q}ualitative {R}esearch ; {B}urkina {F}aso ; {BURKINA} {FASO}},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {H}ealth {P}olicy and {M}anagement},
  volume = {8},
  numero = {5},
  pages = {272--279},
  year = {2019},
  DOI = {10.15171/ijhpm.2018.133},
  URL = {https://www.documentation.ird.fr/hor/fdi:010075544},
}