TY - JOUR
T1 - Pay for performance in Nigeria
T2 - the influence of context and implementation on results
AU - Ogundeji, Yewande Kofoworola
AU - Jackson, Cath
AU - Sheldon, Trevor
AU - Olubajo, Olalekan
AU - Ihebuzor, Nnenna
N1 - © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2016/10
Y1 - 2016/10
N2 - Pay-for-performance (P4P) has recently been introduced in Nigeria to improve quality of health services. Its early results show significant variation between implementation sites. Literature suggests this might be explained by differences in design, context and implementation of the scheme. This study aimed to explore how context and implementation influence P4P in Nigeria. Semi-structured in-depth interviews with 36 health workers explored their views and experiences on how contextual and implementation factors influenced the impact of the P4P scheme. Data were analysed using the framework approach. Four themes captured the views and experiences of participants. Uncertainty of earning the incentive and inadequate infrastructure reduced health worker motivation and performance results; whilst adequate health worker understanding of the scheme and good managerial skills (health facility level) improved motivation and performance. Minimising delays in incentive payments, effective communication and improving the health workers understanding of the P4P scheme are likely to improve the outcomes of pay for performance programmes, independent of their design.
AB - Pay-for-performance (P4P) has recently been introduced in Nigeria to improve quality of health services. Its early results show significant variation between implementation sites. Literature suggests this might be explained by differences in design, context and implementation of the scheme. This study aimed to explore how context and implementation influence P4P in Nigeria. Semi-structured in-depth interviews with 36 health workers explored their views and experiences on how contextual and implementation factors influenced the impact of the P4P scheme. Data were analysed using the framework approach. Four themes captured the views and experiences of participants. Uncertainty of earning the incentive and inadequate infrastructure reduced health worker motivation and performance results; whilst adequate health worker understanding of the scheme and good managerial skills (health facility level) improved motivation and performance. Minimising delays in incentive payments, effective communication and improving the health workers understanding of the P4P scheme are likely to improve the outcomes of pay for performance programmes, independent of their design.
KW - Behaviour change
KW - Developing countries
KW - Formative research
KW - Health financing
KW - Incentives
KW - Primary health care
KW - Attitude of Health Personnel
KW - Humans
KW - Interviews as Topic
KW - Quality Improvement/economics
KW - Developing Countries
KW - Delivery of Health Care/economics
KW - Qualitative Research
KW - Health Personnel/economics
KW - Nigeria
KW - Reimbursement, Incentive/economics
UR - http://www.scopus.com/inward/record.url?scp=84994762031&partnerID=8YFLogxK
U2 - 10.1093/heapol/czw016
DO - 10.1093/heapol/czw016
M3 - Article
C2 - 27036415
SN - 1460-2237
VL - 31
SP - 955
EP - 963
JO - Health Policy and Planning
JF - Health Policy and Planning
IS - 8
ER -