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The unintended consequences of community verifications for performance-based financing in Burkina Faso

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  • Turcotte-Tremblay, Anne-Marie
  • Gali-Gali, Idriss Ali
  • De Allegri, Manuela
  • Ridde, Valéry

Abstract

Performance-based financing (PBF) is being widely implemented to improve healthcare services in Africa. An essential component of PBF involves conducting community verifications, wherein investigators from local associations attempt to trace samples of patients. Community surveys are administered to patients to verify whether healthcare workers reported fictitious services to increase their revenue. At the same time, client satisfaction surveys are administered to assess whether patients are satisfied with the services received. Although some global health actors are concerned that PBF can trigger unintended consequences, this topic remains neglected. The objective of this study was to document the unintended consequences of community verification. Guided by the diffusion of innovations theory, we conducted a multiple case study. The cases were the catchment areas of seven healthcare facilities in Burkina Faso. Data were collected between January 2016 and May 2016 using non-participant observation, 92 semi-structured interviews, and informal discussions. Participants included a wide range of stakeholders, such as community verifiers, investigators, patients, and healthcare providers. Data were coded using QDA Miner, and thematic analysis was conducted. Healthcare workers did not significantly disturb or try to influence community verifiers during patient selection for community verifications. Unintended consequences included stakeholders’ dissatisfaction regarding compensation modalities, work overload for community verifiers, and falsification of verification data by investigators. Community verifications led to loss of patient confidentiality as well as fears and apprehensions, although some patients were pleased to share their views regarding healthcare services. Community verifications also triggered marital issues, resulting in conflicts with, or interference from, husbands. The numerous challenges associated with locating patients in their communities led stakeholders to question the validity and utility of the results. These unintended consequences could jeopardize the overall effectiveness of community verifications. Attention should be paid to these unintended consequences to inform effective implementation and refine future interventions.

Suggested Citation

  • Turcotte-Tremblay, Anne-Marie & Gali-Gali, Idriss Ali & De Allegri, Manuela & Ridde, Valéry, 2017. "The unintended consequences of community verifications for performance-based financing in Burkina Faso," Social Science & Medicine, Elsevier, vol. 191(C), pages 226-236.
    • Handle: RePEc:eee:socmed:v:191:y:2017:i:c:p:226-236
    DOI: 10.1016/j.socscimed.2017.09.007
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    References listed on IDEAS

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    1. Adrien Renaud & Jean-Paul Semasaka, 2014. "Verification of Performance in Results-Based Financing (RBF): The Case of Community and Demand-Side RBF in Rwanda," Health, Nutrition and Population (HNP) Discussion Paper Series 91772, The World Bank.
    2. repec:wbk:wbpubs:17194 is not listed on IDEAS
    3. Anne-Marie Turcotte-Tremblay & Jessica Spagnolo & Manuela De Allegri & Valéry Ridde, 2016. "Does performance-based financing increase value for money in low- and middle- income countries? A systematic review," Health Economics Review, Springer, vol. 6(1), pages 1-18, December.
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    1. Susann Stritzke & Carlos Sakyi-Nyarko & Iwona Bisaga & Malcolm Bricknell & Jon Leary & Edward Brown, 2021. "Results-Based Financing (RBF) for Modern Energy Cooking Solutions: An Effective Driver for Innovation and Scale?," Energies, MDPI, vol. 14(15), pages 1-39, July.
    2. Melberg, Andrea & Diallo, Abdoulaye Hama & Storeng, Katerini T. & Tylleskär, Thorkild & Moland, Karen Marie, 2018. "Policy, paperwork and ‘postographs’: Global indicators and maternity care documentation in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 215(C), pages 28-35.
    3. Singh, Neha S. & Kovacs, Roxanne J. & Cassidy, Rachel & Kristensen, Søren R. & Borghi, Josephine & Brown, Garrett W., 2021. "A realist review to assess for whom, under what conditions and how pay for performance programmes work in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 270(C).
    4. Yvonne Beaugé & Manuela De Allegri & Samiratou Ouédraogo & Emmanuel Bonnet & Naasegnibe Kuunibe & Valéry Ridde, 2020. "Do Targeted User Fee Exemptions Reach the Ultra-Poor and Increase their Healthcare Utilisation? A Panel Study from Burkina Faso," IJERPH, MDPI, vol. 17(18), pages 1-21, September.

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