@article{fdi:010076662,
  title = {{S}takeholder perceptions and context of the implementation of performance-based financing in district hospitals in {M}ali},
  author = {{Z}itti, {T}. and {G}autier, {L}. and {C}oulibaly, {A}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}o improve the performance of the healthcare system, {M}ali's government implemented a pilot project of performance-based financing ({PBF}) in the field of reproductive health. {I}t was established in the {K}oulikoro region. {T}his research analyses the process of implementing {PBF} at district hospital ({DH}) level, something which has rarely been done in {A}frica. {M}ethods: {T}his qualitative research is based on a multiple, explanatory, and contrasting case study with nested levels of analysis. {I}t covered three of the 10 {DH}s in the {K}oulikoro region. {W}e conducted 36 interviews: 12 per {DH} with council of circle's members (2) and health personnel (10). {W}e also conducted 24 non-participant observation sessions, 16 informal interviews, and performed a literature review. {W}e performed data analysis using the {C}onsolidated {F}ramework for {I}mplementation {R}esearch ({CFIR}). {R}esults: {S}takeholders perceived the {PBF} pilot project as a vertical intervention from outside that focused solely on reproductive health. {L}ocal actors were not involved in the design of the {PBF} model. {S}everal difficulties regarding the quality of its design and implementation were highlighted: too short duration of the intervention (8 months), choice and insufficient number of indicators according to the priority of the donors, and impossibility of making changes to the model during its implementation. {A}ll health workers adhered to the principles of {PBF} intervention. {E}xcept for members of the district health management team ({DHMT}) involved in the implementation, respondents only had partial knowledge of the {PBF} intervention. {T}he implementation of {PBF} appeared to be easier in {D}istrict 3 {H}ospital compared to {D}istrict 1 and {D}istrict 2 because it benefited from a pre-pilot project and had good leadership. {C}onclusion: {T}he {PBF} programme offered an opportunity to improve the quality of care provided to the population through the motivation of health personnel in {M}ali. {H}owever, several obstacles were observed during the implementation of the {PBF} pilot project in {DH}s. {W}hen designing and implementing {PBF} in {DH}s, it is necessary to consider factors that can influence the implementation of a complex intervention.},
  keywords = {{P}erformance-{B}ased {F}inancing ; {M}ali ; {I}mplementation ; {CFIR} ; {D}istrict ; {H}ospitals ; {MALI}},
  booktitle = {},
  journal = {{I}nternational {J}ournal of {H}ealth {P}olicy and {M}anagement},
  volume = {8},
  numero = {10},
  pages = {583--592},
  year = {2019},
  DOI = {10.15171/ijhpm.2019.45},
  URL = {https://www.documentation.ird.fr/hor/fdi:010076662},
}