A comparative study of community verification processes in the context of performance-based financing in Mali and Burkina Faso

Tony Zitti, Abdouramane Coulibaly, Idriss Ali Gali-Gali, V. Ridde, Anne-Marie Turcotte-Tremblay
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In Burkina Faso, 241 non-participatory observation sessions were recorded in a research diary, and 92 semi-structured interviews and informal discussions were conducted with investigators, community verifiers, users, PBF support staff at the national level, and administrative staff in one of the 15 health districts involved in PBF. The data were analysed inductively.FindingsIn both Mali and Burkina Faso, the delayed availability of survey forms led to a delay in starting the surveys. In Mali, to get off to a quick start, some investigators went to health centres to conduct the sampling with their supervisors. In both countries, investigators reported difficulties in finding certain users in the community due to incorrect spelling of names, lack of telephone details, incomplete information on the forms, common or similar sounding names within the community, and user mobility. There was little interference from health workers during user selection and surveys in both countries. In both countries, many surveys were conducted in the presence of the user's family (husband, father-in-law, brother, uncle, etc.) and the person accompanying the investigator. Also in both countries, some investigators filled in forms without investigating. They justified this data fabrication by the inadequate time available for the survey and the difficulty or impossibility of finding certain users. In both countries, the results were not communicated to health centre staff or users in either country.Research limitations/implicationsCV and user satisfaction surveys are important components of PBF implementation. However, their implementation and evaluation remain complex. The instruments for CV and user satisfaction surveys for PBF need to be adapted and simplified to the local context. Emphasis should be placed on data analysis and the use of CV results.Originality/valueThere are similarities and differences in the CV process and user satisfaction surveys in Mali and Burkina Faso. In Mali, the data from the user satisfaction survey was not analyzed, while in Burkina Faso, the analysis did not allow for feedback. The local non-governmental organisations (NGOs) that carried out the CV were pre-financed for 50% of the amount in Mali. In Burkina Faso, community-based organisations (CBOs) were not pre-financed. The lack of financing negatively impacted the conduction of the surveys. In Mali, fraudulent completion of survey forms by interviewers was more common in urban than in rural areas. In Burkina Faso, the frauds concerned consultations for children under five years of age. In Burkina Faso, the survey form was not adapted to collect data on the level of satisfaction of the indigent.Key messagesThere were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.In both countries, there was no feedback on the results of the CV process to health centre staff or users.Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. 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Abstract

PurposeThis article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina Faso.Design/methodology/approachThe authors adopted a qualitative approach based on a multiple-case study design. Data were collected from August 10 to 25, 2017, in Mali, and from January to May 2016 in Burkina Faso. In Mali, 191 semi-structured interviews were conducted with investigators (people who collect information from health centre users in the communities, using survey tools), users, users' relatives, and health workers in three of the 10 health districts in the Koulikoro region. In Burkina Faso, 241 non-participatory observation sessions were recorded in a research diary, and 92 semi-structured interviews and informal discussions were conducted with investigators, community verifiers, users, PBF support staff at the national level, and administrative staff in one of the 15 health districts involved in PBF. The data were analysed inductively.FindingsIn both Mali and Burkina Faso, the delayed availability of survey forms led to a delay in starting the surveys. In Mali, to get off to a quick start, some investigators went to health centres to conduct the sampling with their supervisors. In both countries, investigators reported difficulties in finding certain users in the community due to incorrect spelling of names, lack of telephone details, incomplete information on the forms, common or similar sounding names within the community, and user mobility. There was little interference from health workers during user selection and surveys in both countries. In both countries, many surveys were conducted in the presence of the user's family (husband, father-in-law, brother, uncle, etc.) and the person accompanying the investigator. Also in both countries, some investigators filled in forms without investigating. They justified this data fabrication by the inadequate time available for the survey and the difficulty or impossibility of finding certain users. In both countries, the results were not communicated to health centre staff or users in either country.Research limitations/implicationsCV and user satisfaction surveys are important components of PBF implementation. However, their implementation and evaluation remain complex. The instruments for CV and user satisfaction surveys for PBF need to be adapted and simplified to the local context. Emphasis should be placed on data analysis and the use of CV results.Originality/valueThere are similarities and differences in the CV process and user satisfaction surveys in Mali and Burkina Faso. In Mali, the data from the user satisfaction survey was not analyzed, while in Burkina Faso, the analysis did not allow for feedback. The local non-governmental organisations (NGOs) that carried out the CV were pre-financed for 50% of the amount in Mali. In Burkina Faso, community-based organisations (CBOs) were not pre-financed. The lack of financing negatively impacted the conduction of the surveys. In Mali, fraudulent completion of survey forms by interviewers was more common in urban than in rural areas. In Burkina Faso, the frauds concerned consultations for children under five years of age. In Burkina Faso, the survey form was not adapted to collect data on the level of satisfaction of the indigent.Key messagesThere were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso.In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility.In both countries, there was no feedback on the results of the CV process to health centre staff or users.Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.
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马里和布基纳法索基于绩效的融资背景下社区核查过程的比较研究
本文比较了马里和布基纳法索实施绩效融资(PBF)过程中的社区验证(CV)和用户满意度调查过程。设计/方法/方法作者采用了基于多案例研究设计的定性方法。数据于2017年8月10日至25日在马里和2016年1月至5月在布基纳法索收集。在马里,对库利科罗地区10个卫生区中的3个区的调查人员(使用调查工具向社区卫生中心用户收集信息的人员)、用户、用户亲属和卫生工作者进行了191次半结构化访谈。在布基纳法索,研究日记记录了241次非参与性观察会议,并与调查人员、社区核查人员、用户、国家一级的PBF支助人员以及参与PBF的15个卫生区之一的行政人员进行了92次半结构化访谈和非正式讨论。对数据进行了归纳分析。在马里和布基纳法索,调查表格的延迟发放导致了调查的延迟开始。在马里,为了快速开始,一些调查人员前往保健中心与他们的主管一起进行抽样。在这两个国家,调查人员报告说,由于姓名拼写错误、缺乏电话详细信息、表格上的信息不完整、社区内常见或发音相似的名称以及用户的流动性,很难在社区中找到某些用户。在这两个国家的用户选择和调查过程中,卫生工作者几乎没有干预。在这两个国家,许多调查都是在用户的家人(丈夫、岳父、兄弟、叔叔等)和陪同调查者的人在场的情况下进行的。同样在这两个国家,一些调查人员在没有调查的情况下填写了表格。他们以调查时间不足和难以或不可能找到某些用户为理由来证明这种捏造数据的行为。在这两个国家,结果都没有传达给任何一个国家的保健中心工作人员或使用者。研究局限/启示scv和用户满意度调查是PBF实施的重要组成部分。然而,它们的执行和评价仍然很复杂。CV和PBF用户满意度调查的工具需要根据当地情况进行调整和简化。重点应放在数据分析和CV结果的使用上。原创性/价值在马里和布基纳法索,CV流程和用户满意度调查既有相似之处,也有不同之处。在马里,没有对用户满意度调查的数据进行分析,而在布基纳法索,分析不允许反馈。在马里,执行CV的当地非政府组织(ngo)获得了50%的预付款。在布基纳法索,社区组织(cbo)没有得到预先资助。缺乏资金对调查的进行产生不利影响。在马里,城市地区的采访者虚假填写调查表的现象比农村地区更为普遍。在布基纳法索,欺诈涉及五岁以下儿童的咨询。在布基纳法索,调查表格不适于收集关于穷人满意程度的数据。关键信息马里和布基纳法索的社区核查(CV)过程有相似之处,也有差异。在马里和布基纳法索,在其社区内追踪用户很困难,原因包括表格信息不正确或不完整、姓名相同或相似以及用户流动性。在这两个国家,没有向保健中心工作人员或用户反馈CV过程的结果。两国的调查人员都伪造了调查表格。在马里,城市地区的弄虚作假比农村地区更为普遍。在布基纳法索,为五岁以下儿童提供咨询时更经常看到伪造情况。
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来源期刊
CiteScore
5.00
自引率
7.10%
发文量
32
期刊介绍: The International Journal of Public Sector Management (IJPSM) publishes academic articles on the management, governance, and reform of public sector organizations around the world, aiming to provide an accessible and valuable resource for academics and public managers alike. IJPSM covers the full range of public management research including studies of organizations, public finances, performance management, Human Resources Management, strategy, leadership, accountability, integrity, collaboration, e-government, procurement, and more. IJPSM encourages scholars to publish their empirical research and is particularly interested in comparative findings. IJPSM is open to articles using a variety of research methods and theoretical approaches.
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