De la mise en oeuvre de la politique de gouvernance basée sur la performance au District sanitaire de Buhiga

Abstract

The Burundian health system has long favored the input approach in its governance system. With performance-based financing, it is the output approach (results, performance) that is driving the system. This consists of financing health care and services according to the performance achieved by the health structures and on the basis of quantitative and qualitative indicators defined beforehand. Since 2010, the PBF policy has been implemented at the national level. Our study focused on the implementation of the PBF policy in the Buhiga Health District. The main objective was to analyze the dynamics surrounding the implementation of this policy. The results of our research showed that the implementation of PBF faces three problems: First, the Burundian health system is experiencing organizational problems that impact the implementation of the PBF. Second, some actors have not yet adopted the approach. Finally, certain dysfunctions in the PBF approach lead to perverse effects.