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32 papers found.
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Household costs and time to seek care for pregnancy related complications: The role of results-based financing

Results-based financing (RBF) schemes–including performance based financing (PBF) and conditional cash transfers (CCT)-are increasingly being used to encourage use and improve quality of institutional health care for pregnant women in order to reduce maternal and neonatal mortality in low-income countries. While there is emerging evidence that RBF can increase service use and ...

A qualitative study assessing the acceptability and adoption of implementing a results based financing intervention to improve maternal and neonatal health in Malawi

Background Results Based Financing (RBF) interventions have recently gained significant momentum, especially in sub-Saharan Africa. However, most of the research has focused on the evaluation of the impacts of this approach, providing little insight into how the contextual circumstances surrounding the implementation have contributed to its success or failure. This study aims to ...

The economic burden of chronic non-communicable diseases in rural Malawi: an observational study

Forschungsgemeinschaft - DFG) - grant number is DFGAL1361/2-1 awarded to Manuela De Allegri. Qun Wang was funded by China Scholarship Council. Open Access Publication was made possible by DFG funding awarded to Heidelberg

A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries

Background Poor access and low contraceptive prevalence are common to many Low- and Middle-Income Countries (LMICs). Unmet need for family planning (FP), defined as the proportion of women wishing to limit or postpone child birth, but not using contraception, has been central to reproductive health efforts for decades and still remains relevant for most policy makers and FP ...

Evaluating complex health financing interventions: using mixed methods to inform further implementation of a novel PBI intervention in rural Malawi

Background Gaps remain in understanding how performance-based incentive (PBI) programs affect quality of care and service quantity, whether programs are cost effective and how programs could be tailored to meet client and provider needs while remaining operationally viable. In 2014, Malawi’s Ministry of Health launched the Service Delivery Integration-PBI (SSDI-PBI) program. The ...

Understanding home delivery in a context of user fee reduction: a cross-sectional mixed methods study in rural Burkina Faso

Background Several African countries have recently reduced/removed user fees for maternal care, producing considerable increases in the utilization of delivery services. Still, across settings, a conspicuous number of women continue to deliver at home. This study explores reasons for home delivery in rural Burkina Faso, where a successful user fee reduction policy is in place since ...

Does performance-based financing increase value for money in low- and middle- income countries? A systematic review

Governments of low- and middle-income countries (LMICs) are widely implementing performance-based financing (PBF) to improve healthcare services. However, it is unclear whether PBF provides good value for money compared to status quo or other interventions aimed at strengthening the healthcare system in LMICs. The objective of this systematic review is to identify and synthesize ...

Gaps in universal health coverage in Malawi: A qualitative study in rural communities

Background In sub-Saharan Africa, universal health coverage (UHC) reforms have often adopted a technocratic top-down approach, with little attention being paid to the rural communities’ perspective in identifying context specific gaps to inform the design of such reforms. This approach might shape reforms that are not sufficiently responsive to local needs. Our study explored how ...

How do Malawian women rate the quality of maternal and newborn care? Experiences and perceptions of women in the central and southern regions

Background While perceived quality of care is now widely recognized to influence health service utilization, limited research has been conducted to explore and measure perceived quality of care using quantitative tools. Our objective was to measure women’s perceived quality of maternal and newborn care using a composite scale and to identify individual and service delivery factors ...

Factors Affecting the Uptake of HIV Testing among Men: A Mixed-Methods Study in Rural Burkina Faso

Background This study aimed to explore factors shaping the decision to undergo Human Immunodeficiency Virus (HIV) testing among men in rural Burkina Faso. Methods The study took place in 2009 in the Nouna Health District and adopted a triangulation mixed methods design. The quantitative component relied on data collected through a structured survey on a representative sample of ...

Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: a meta-analysis of population-based cohort studies

Background Facility-based delivery has gained traction as a key strategy for reducing maternal and perinatal mortality in developing countries. However, robust evidence of impact of place of delivery on maternal and perinatal mortality is lacking. We aimed to estimate the risk of maternal and perinatal mortality by place of delivery in sub-Saharan Africa. Methods We conducted a ...

The Quality of Clinical Maternal and Neonatal Healthcare – A Strategy for Identifying ‘Routine Care Signal Functions’

Background A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the ‘EmOC signal ...

Out-of-Pocket Expenditure on Chronic Non-Communicable Diseases in Sub-Saharan Africa: The Case of Rural Malawi

In Sub-Saharan Africa (SSA) the disease burden of chronic non-communicable diseases (CNCDs) is rising considerably. Given weaknesses in existing financial arrangements across SSA, expenditure on CNCDs is often borne directly by patients through out-of-pocket (OOP) payments. This study explored patterns and determinants of OOP expenditure on CNCDs in Malawi. We used data from the ...

“It’s not easy to acknowledge that I’m ill”: a qualitative investigation into the health seeking behavior of rural Palestinian women

Background This qualitative study sets to fill a gap in knowledge by exploring the health seeking behaviour of rural women living in the occupied Palestinian territories (oPt). The existing literature on the oPt has so far focused on unravelling the country’s epidemiological and health system profile, but has largely neglected the assessment of factors shaping people’s decisions on ...

Do community-based health insurance schemes fulfil the promise of equity? A study from Burkina Faso

Objective: To examine whether the community-based health insurance (CBHI) scheme in Burkina Faso has been effective in providing equitable healthcare access to poor individuals, women, children and those living far from health facilities. Methods: We used the Nouna Health District Household Survey to collect panel data on 990 households during 2004–08. By applying a series of ...

Logistic, ethical, and political dimensions of stepped wedge trials: critical review and case studies

Background Three arguments are usually invoked in favour of stepped wedge cluster randomised controlled trials: the logistic convenience of implementing an intervention in phases, the ethical benefit of providing the intervention to all clusters, and the potential to enhance the social acceptability of cluster randomised controlled trials. Are these alleged benefits real? We ...

Insecticide-treated mosquito nets in rural Burkina Faso: assessment of coverage and equity in the wake of a universal distribution campaign

Insecticide-treated mosquito nets (ITNs) are an essential tool of the Roll Back Malaria strategy. An increasing number of African countries have embarked on mass distribution campaigns of long-lasting insecticide-treated nets (LLINs) with the ultimate goal of universal coverage. Such a national campaign with the goal of one ITN for every two people has been conducted in Burkina ...

Developing attributes and attribute-levels for a discrete choice experiment on micro health insurance in rural Malawi

Bongololo Mbera 4 Paul J Robyn 3 Manuela De Allegri 1 0 Department of Planning and Management, Faculty of Planning and Land Management, University for Development Studies , Wa , Ghana 1 Institute of Public

Design of an impact evaluation using a mixed methods model – an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi

Stephan Brenner 0 Adamson S Muula Paul Jacob Robyn Till Brnighausen Malabika Sarker 0 Don P Mathanga Thomas Bossert Manuela De Allegri 0 0 Institute of Public Health, Ruprecht-Karls-University

Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso

1 Aurélia Souares Julia Lohmann David Zombré 0 1 Jean Louis Koulidiati Maurice Yaogo Hervé Hien Matthew Hunt Sylvie Zongo Manuela De Allegri 0 University of Montreal School of Public Health , 7101