肯尼亚县级基于绩效的融资的政治优先考虑:2015年至2018年
Dennis Waithaka1, Lucy Gilson2,3, Edwine Barasa1,4
1Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
International journal of health policy and management
|August 14, 2023
概括
肯尼亚基利菲县的基于绩效的融资 (PBF) 受到了当地政治和官僚行为者的影响. 了解这些影响对于在权力下放治理环境中成功实施卫生改革至关重要.
科学领域:
- 公共卫生政策 公共卫生政策
- 加强卫生系统 加强卫生系统
- 卫生经济学 卫生经济学
背景情况:
- 基于绩效的融资 (PBF) 从2015年开始在肯尼亚基利菲县实施.
- 当地政治和官僚行为者在次国家层面对PBF的优先级产生了重大影响.
研究的目的:
- 调查地方参与者对PBF优先级制定的影响背后的机制和原因.
- 了解政治和官僚动态如何塑造了基利菲县PBF的实施.
主要方法:
- 采用了单个案例研究设计.
- 史密斯和希夫曼的政治优先设定框架,由沃尔特和吉尔森改编,指导了这项研究.
- 数据收集涉及文档审查 (n=19) 和深度访谈 (n=8),使用框架分析进行分析.
主要成果:
- 由于权力下放和严格的财务管理结构,PBF优先级受到了影响.
- 对"绩效支付"的解释和将其作为"额外资金"的定义发挥了作用.
- 关于PBF设计特征的次国家级参与者之间的争议以及在捐助者资金结束后在2018年停止PBF是关键结果.
结论:
- 卫生改革者必须考虑国家和次国家参与者的影响,政治和官僚.
- 持续的关注和预算承诺在权力下放的治理环境中至关重要.
- 关键参与者的早期参与是必要的,以促进对改革理念和目标的共同理解.
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