Assessing the effect of results-based financing on the maternal, newborn, and child health indicators for a community health program in Kyotera District, Uganda

Abstract

Background: The study recognizes the pressing need for improved Maternal, Newborn, and Child Health (MNCH) outcomes in Uganda, where a significant number of women still receive limited antenatal care and give birth outside of healthcare facilities. These factors contribute to alarmingly high maternal and infant mortality rates. Results based financing (RBF) has been proposed as a financing a mechanism that can motivate providers to deliver both improved quantity and quality of services. Despite this potential of RBF, there is inadequate documented evidence and limited robust evaluations on its effectiveness in different contextual settings. Method: A case study design utilizing mixed methods approach was employed to assess the effect of community health Results Based Financing intervention. The quantitative approach was based on a single interrupted time series using secondary data collected by community health workers from June 2017 to December 2019. A qualitative approach of data collection was used, key informant interviews, and document review were used as primary data collection methods. The data collected using interviews, and document reviews was analyzed using thematic analysis techniques. Results: Preliminary findings indicate notable improvements in MNCH indicators. Following RBF implementation, pregnant women delivering at health facilities and malaria treatment cases for children under-five years experienced substantial increases. RBF led to increased emphasis on pregnancy care visits, which in turn improved antenatal care visits, health facility deliveries, and postnatal care visits. Stronger relationships with health facilities also contributed to a significant increase in health facility deliveries. Conclusions: This research provides robust evidence of RBF's positive impact on MNCH outcomes. The results underscore the importance of training, community sensitization, data verification. However, challenges related to data verification and incentive structures warrant further consideration in future RBF interventions to optimize their effectiveness and sustainability.