Mathieu Seppey, Paul-André Somé and Valéry Ridde
A performance-based financing (PBF) pilot project was implemented in 2011 in Burkina Faso. After more than five years of implementation (data collection in 2016), the project's…
Abstract
Purpose
A performance-based financing (PBF) pilot project was implemented in 2011 in Burkina Faso. After more than five years of implementation (data collection in 2016), the project's sustainability was not guaranteed. This study's objective is to assess this project's sustainability in 2016 by identifying the presence/absence of different determinants of sustainability according to the conceptual framework of Seppey et al. (2017).
Design/methodology/approach
It uses a case study approach using in-depth interviews with various actors at the local, district/regional and national levels. Participants (n = 37) included health practitioners, management team members, implementers and senior members of health directions. A thematic analysis based on the conceptual framework was conducted, as well as an inductive analysis.
Findings
Results show the project's sustainability level was weak according to an unequal presence of sustainability's determinants; some activities are being maintained but not fully routinised. Discrepancies between the project and the context's values appeared to be important barriers towards sustainability. Project's ownership by key stakeholders also seemed superficial despite the implementers' leadership towards its success. The project's objective towards greater autonomy for health centres was also directly confronting the Burkinabe's hierarchical health system.
Originality/value
This study reveals many fits and misfits between a PBF project and its context affecting its ability to sustain activities through time. It also underlines the importance of using a conceptual framework in implementing and evaluating interventions. These results could be interesting for decision-makers and implementers in further assessing PBF projects elsewhere.
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Elisabeth Paul, Oriane Bodson and Valéry Ridde
The study aims to explore the theoretical bases justifying the use of performance-based financing (PBF) in the health sector in low- and middle-income countries (LMICs).
Abstract
Purpose
The study aims to explore the theoretical bases justifying the use of performance-based financing (PBF) in the health sector in low- and middle-income countries (LMICs).
Design/methodology/approach
The authors conducted a scoping review of the literature on PBF so as to identify the theories utilized to underpin it and analyzed its theoretical justifications.
Findings
Sixty-four studies met the inclusion criteria. Economic theories were predominant, with the principal-agent theory being the most commonly-used theory, explicitly referred to by two-thirds of included studies. Psychological theories were also common, with a wide array of motivation theories. Other disciplines in the form of management or organizational science, political and social science and systems approaches also contributed. However, some of the theories referred to contradicted each other. Many of the studies included only casually alluded to one or more theories, and very few used these theories to justify or support PBF. No theory emerged as a dominant, consistent and credible justification of PBF, perhaps except for the principal-agent theory, which was often inappropriately applied in the included studies, and when it included additional assumptions reflecting the contexts of the health sector in LMICs, might actually warn against adopting PBF.
Practical implications
Overall, this review has not been able to identify a comprehensive, credible, consistent, theoretical justification for using PBF rather than alternative approaches to health system reforms and healthcare providers' motivation in LMICs.
Originality/value
The theoretical justifications of PBF in the health sector in LMICs are under-documented. This review is the first of this kind and should encourage further debate and theoretical exploration of the justifications of PBF.
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Tony Zitti, Abdouramane Coulibaly, Idriss Ali Zakaria Gali-Gali, Valery Ridde and Anne-Marie Turcotte-Tremblay
This article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina…
Abstract
Purpose
This article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina Faso.
Design/methodology/approach
The authors adopted a qualitative approach based on a multiple-case study design. Data were collected from August 10 to 25, 2017, in Mali, and from January to May 2016 in Burkina Faso. In Mali, 191 semi-structured interviews were conducted with investigators (people who collect information from health centre users in the communities, using survey tools), users, users' relatives, and health workers in three of the 10 health districts in the Koulikoro region. In Burkina Faso, 241 non-participatory observation sessions were recorded in a research diary, and 92 semi-structured interviews and informal discussions were conducted with investigators, community verifiers, users, PBF support staff at the national level, and administrative staff in one of the 15 health districts involved in PBF. The data were analysed inductively.
Findings
In both Mali and Burkina Faso, the delayed availability of survey forms led to a delay in starting the surveys. In Mali, to get off to a quick start, some investigators went to health centres to conduct the sampling with their supervisors. In both countries, investigators reported difficulties in finding certain users in the community due to incorrect spelling of names, lack of telephone details, incomplete information on the forms, common or similar sounding names within the community, and user mobility. There was little interference from health workers during user selection and surveys in both countries. In both countries, many surveys were conducted in the presence of the user's family (husband, father-in-law, brother, uncle, etc.) and the person accompanying the investigator. Also in both countries, some investigators filled in forms without investigating. They justified this data fabrication by the inadequate time available for the survey and the difficulty or impossibility of finding certain users. In both countries, the results were not communicated to health centre staff or users in either country.
Research limitations/implications
CV and user satisfaction surveys are important components of PBF implementation. However, their implementation and evaluation remain complex. The instruments for CV and user satisfaction surveys for PBF need to be adapted and simplified to the local context. Emphasis should be placed on data analysis and the use of CV results.
Originality/value
There are similarities and differences in the CV process and user satisfaction surveys in Mali and Burkina Faso. In Mali, the data from the user satisfaction survey was not analyzed, while in Burkina Faso, the analysis did not allow for feedback. The local non-governmental organisations (NGOs) that carried out the CV were pre-financed for 50% of the amount in Mali. In Burkina Faso, community-based organisations (CBOs) were not pre-financed. The lack of financing negatively impacted the conduction of the surveys. In Mali, fraudulent completion of survey forms by interviewers was more common in urban than in rural areas. In Burkina Faso, the frauds concerned consultations for children under five years of age. In Burkina Faso, the survey form was not adapted to collect data on the level of satisfaction of the indigent.
Key messages
There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.
In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.
In both countries, there was no feedback on the results of the CV process to health centre staff or users.
Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.
There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.
In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.
In both countries, there was no feedback on the results of the CV process to health centre staff or users.
Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.
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Adhi Alfian, Hamzah Ritchi and Zaldy Adrianto
Increased fraudulent practices have heightened the need for innovation in anti-fraud programs, necessitating the development of analytics techniques for detecting and preventing…
Abstract
Purpose
Increased fraudulent practices have heightened the need for innovation in anti-fraud programs, necessitating the development of analytics techniques for detecting and preventing fraud. The subject of fraud analytics will continue to expand in the future for public-sector organizations; therefore, this research examined the progress of fraud analytics in public-sector transactions and offers suggestions for its future development.
Design/methodology/approach
This study systematically reviewed research on fraud analytics development in public-sector transactions. The review was conducted from June 2021 to June 2023 by identifying research objectives and questions, performing literature quality assessment and extraction, data synthesis and research reporting. The research mainly identified 43 relevant articles that were used as references.
Findings
This research examined fraud analytics development related to public-sector financial transactions. The results revealed that fraud analytics expansion has not spread equally, as most programs have been implemented by governments and healthcare organizations in developed countries. This research also exposed that the analytics optimization in fraud prevention is higher than for fraud detection. Such analytics help organizations detect fraud, improve business effectiveness and efficiency, and refine administrative systems and work standards.
Research limitations/implications
This research offers comprehensive insights for researchers and public-sector professionals regarding current fraud analytics development in public-sector financial transactions and future trends.
Originality/value
This study presents the first systematic literature review to investigate the development of fraud analytics in public-sector transactions. The findings can aid scholars' and practitioners' future fraud analytics development.
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Rovier Djeudja and Yang Salamon
The purpose of this study is to evaluate the contribution of the business climate on the sustainability of Cameroonian small- and medium-sized enterprises (SMEs) in times of…
Abstract
Purpose
The purpose of this study is to evaluate the contribution of the business climate on the sustainability of Cameroonian small- and medium-sized enterprises (SMEs) in times of coronavirus disease 2019 (COVID-19).
Design/methodology/approach
To achieve this purpose, the study proceed with a quantitative analysis using the simple LOGIT model on a sample of 52 individuals.
Findings
Through the administration of questionnaires and estimations, results reveal that certain variables such as the taxation regime of the enterprise, the different types of taxes paid by the enterprise, the frequency of payment of income tax, the nature of the training of managers, the clauses of the debt contracts with banks/EMFs (Microfinance institution), the time taken to apply for a loan from the bank and the nature of the manager’s training have a negative influence on the sustainability of Cameroonian SMEs during COVID-19, while others such as the evolution of financial profitability in the context of the coronavirus pandemic in Cameroon, the company’s sector of activity and the main methods of financing the SME have a positive influence on the sustainability of Cameroonian SMEs during COVID-19 pandemic. The improvement of the business climate by the institutional authorities is, therefore, essential in the perspective of an eventual development of the country; the said development cannot take place without capitalizing on the potential for income and job creation by SMEs.
Research limitations/implications
The first limitation is related to the size of the sample and also to the specificity of our study. In fact, the study is conducted among individuals/actors likely to have access to information on the business climate and sustainability of Cameroonian SMEs at the time of COVID-19 encountered in the city of Yaoundé. In this context, the sample size is considered to be small (52). This element does not immediately allow the results of the present research to be generalized to all regions where SMEs are located in Cameroon, as other criteria or other elements must still be taken into account and the results obtained must, therefore, be interpreted with caution. This research could be deepened in the future by considering more business climate variables on the one hand and a larger sample size extended to all cities in Cameroon on the other.
Practical implications
The results of this research confirm the importance of institutional bodies establishing a rigorous policy of support for businesses. Such a policy would contribute to improving the business climate and extend beyond mere resilience.
Originality/value
The originality of this study lies in the fact that it looks at the sustainability of SMEs in the context of the COVID-19 pandemic in Cameroon using a simple LOGIT econometric model.