Systemic factors affecting the technical quality of healthcare in results-based financing in Burkina Faso.

Abstract Background: In the implementation of the results-based financing (PBF) strategy in Burkina Faso, there is heterogeneity in the performance of technical quality of healthcare in basic healthcare facilities. This study aims to identify the factors that may explain this heterogeneity. Methods: We carried out a quantitative study in 30 basic public health facilities, thirteen of which have a quality score greater than or equal to 50% and 17 of which have a quality score less than 50%. Data from their profiles were collected using a direct observation grid. A total of 94 health professionals answered a series of semi-structured questions. A bivariate analysis using the Chi-square test and a multivariate analysis using the multiple regression model were used. Results: The difference is statistically significant in favour of health facilities with good performance in technical quality in terms of health infrastructure (p=0.020), health equipment (p=0.004) and compliance with norms and standards in terms of health personnel (p=0.004). The variables used in the multiple regression model are ongoing training (p=0.000), internal communication (p=0.000) and financial motivation (p=0.003) of health professionals. Conclusion: These results suggest that the effectiveness of the technical quality of healthcare in implementing the PBF depends on certain basic conditions in the health facilities, such as the presence of infrastructures, equipment and human resources that meet established norms and standards and the managerial dynamics of healthcare workers.