Kemri-Wellcome Trust Research Programme: Examining the implementation of performance based financing for primary healthcare in Kenya

Performance based financing (PBF) is a type of results based financing that aims to improve the quantity and quality of healthcare services by offering financial incentives to healthcare workers upon achievement of predefined performance measures. Kenya has introduced PBF for peripheral healthcare facilities in 20 (out of 47) counties. This health system reform has the potential to significantly influence how these facilities operate. Beyond design, how a policy reform is introduced and implemented influences the extent to which it achieves its intended goal. Understanding how PBF in Kenya was introduced and implemented, and how this has influenced its effects is therefore an important research and policy question. This study aims to understand how PBF was designed, implemented and stakeholder perceptions of its intended and unintended effects. It will also examine the changes over time for PBF performance indicators. This will be a mixed-methods study. Qualitative data will be collected through in-depth interviews, focus group discussions and document review, while quantitative data on PBF performance indicators will be extracted from district health information system and evaluation reports. Qualitative data will be analyzed by framework analysis while analysis of PBF indicator changes over time will be conducted on the quantitative data.

Programme: International Masters Fellowship

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