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Factors associated with misreporting in performance-based financing in Burkina Faso: Implications for risk-based
Naasegnibe Kuunibe1, Julia Lohmann1, Michael Schleicher1
1Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Germany.
The International Journal of Health Planning and Management
|April 18, 2019
Summary
Performance-based financing (PBF) verification in Burkina Faso revealed misreporting varied by service and district. Facility characteristics like staff numbers and location influenced reporting accuracy, suggesting a need for risk-based approaches.
Area of Science:
- Health Services Research
- Health Economics
- Public Health Policy
Background:
- Performance-based financing (PBF) is a strategy to enhance health service delivery in low- and middle-income countries (LMICs).
- Quantity verification is crucial in PBF to ensure data accuracy, but cost concerns prompt a shift towards risk-based verification.
- Limited evidence exists on how facility characteristics influence misreporting within PBF programs.
Purpose of the Study:
- To investigate the association between health facility characteristics and data misreporting in a large-scale PBF program in Burkina Faso.
- To identify factors contributing to misreporting to inform the development of risk-based verification strategies.
Main Methods:
- Combined administrative data from a PBF pilot program with health facility assessment data.
- Analyzed data from Burkina Faso to assess overreporting and underreporting of services.
- Examined the relationship between facility characteristics (staffing, catchment population, distance to administration) and misreporting probability.
Main Results:
- Misreporting, encompassing both overreporting and underreporting, was observed and varied across service indicators and health districts.
- Key facility characteristics associated with misreporting included the number of clinical staff, population size of the catchment area, and the facility's distance from district administration.
- While significant associations were identified, the underlying reasons for misreporting by these factors remain unexplained.
Conclusions:
- Facility characteristics are demonstrably linked to the accuracy of reported data in PBF programs.
- Findings support the need for further research into these factors to refine risk-based verification approaches.
- Qualitative inquiry is recommended to understand the mechanisms behind the identified associations and improve verification processes.
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