Sustainability determinants of the Burkinabe performance-based financing project
Bibliographic record
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".