Performance-Based Financing and Primary Health Service Delivery in Ondo State, Nigeria
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Date
2022
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The Department of Public Administration, Faculty of Administration, Obafemi Awolowo University
Abstract
The study examined the strategies employed in the implementation of Performance-based Financing (PBF) on primary health service delivery in Ondo State; assessed the effect of PBF on primary health service delivery in the study area; and analysed the challenges militating against the implementation of PBF to delivery primary health service in the state. These were with a view to providing information on the effect of PBF on primary health service delivery in Ondo State.
The study adopted a survey research design. Primary and secondary data were utilised for the study. Primary data were collected through administration of questionnaire, and conduct of in depth interview. The study population (1,116) comprised management and staff of Comprehensive Health Facilities (216) and the beneficiaries (900) of healthcare service, who were the members of Community Development Councils (CDCs) across the 18 Local Government Areas of the state. Two-stage sampling procedure was adopted in selecting the Comprehensive Health Centres at each of the local government headquarters. Purposive sampling technique was used in selecting the clinical staff among the senior staff of the Comprehensive Health Facilities (CHFs). Due to variations in the population size of the management and staff of the CHFs across the local governments, proportional to size technique was used in determining the number of respondents picked per Comprehensive Health Facility. Thus, 30% (65) of population size of management and staff of Comprehensive Health Facilities were selected. On the other hand, 10% (90) of the population size of members of Community Development Councils (CDCs) were purposively selected, amounting to five CDC members per local government. In total, 155 respondents were selected for questionnaire administration. In addition, the managers of the 18 Comprehensive Health Facilities (CHFs) and the corresponding chairmen of Community Development Councils (CDCs) were purposively selected for interview. Secondary data were sourced from textbooks,
journals, records of Comprehensive Health Facilities (CHFs), and internet. Data collected were analysed using content analysis, frequency distribution, percentages, mean value, and analysis of variance (ANOVA).
The results revealed that quarterly business plan of health facilities, referral procedures, fraud prevention and penalties, and community involvement through Ward Development Committee (WDC) were the strategies employed in the implementation of PBF in Ondo State. The result further showed that PBF promoted health education and availability of essential drugs (̅χ = 3.1), harmonised immunisation and family planning programmes (̅χ = 3.6), maternal and child health care (̅χ = 3.4), and enhanced prevention/control of locally endemic diseases in the study area (̅χ = 3.6). In addition, PBF had a positive effect on primary health service delivery in the study area (t = 7.88, p > 0.05). Finally, the study showed that communication gap between the sponsor and the managers of health facilities (̅χ = 3) as well as irregular payment of performance bonus by Ondo State Primary Health Care Development Board were major challenges of PBF in delivering primary health service (̅χ = 2.8).
The study concluded that performance-based financing positively influenced primary health service delivery in Ondo State.
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xii, 126
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Citation
ALAKO, L.O.(2022). Performance-Based Financing and Primary Health Service Delivery in Ondo State, Nigeria. Department of Public Administration, Faculty of Administration, Obafemi Awolowo University.