Implementation of the Pbf Approach in Maniema, Drc, and Its Consequences: STAFF TURNOVER AND THE IMPLEMENTATION OF PERFORMANCE-BASED FUNDING: THE CASES OF THE LUSANGI AND KASONGO SCHOOL DISTRICTS - Tapa blanda

Sinopsis

Performance-based financing (PBF) is a health system reform strategy aimed at improving the quality of care through financial incentives linked to outcomes. However, its implementation can affect the stability of the health workforce. The objective of this study was to assess the extent of staff instability and to analyze stakeholders' perceptions of associated factors-particularly those related to PBF-in the Lusangi and Kasongo health zones (Maniema Province, DRC). A mixed-methods study, combining a quantitative cross-sectional survey with a qualitative approach using semi-structured interviews, was conducted among 130 health care providers and key informants. Quantitative data were analyzed using EpiData and SPSS 23, while qualitative data were processed using NVivo software. The results show an overall staff turnover rate of 53.8%, which was higher in Kasongo (58%) than in Lusangi (50%). Although 63.1% of respondents appreciate the concept of the FBP, 88.5% consider their compensation insufficient, and 84.6% complain about irregular payments.

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