Factors Inhibiting and Enabling Performance-Based Financing in Health Care Delivery across Low and Middle-Income Countries: A Scoping Review

2024-03-14T01:09:56-04:00

Abstract
Background: Emerging financing strategies in the health sector have been developed to improve the impact of investments and enhance healthcare outcomes. One promising approach is Results-based Financing, which establishes a connection between financial incentives and pre-established performance targets. This innovative approach holds the potential to strengthen healthcare delivery and strengthen overall healthcare systems.
Aim: The scoping review endeavored to systematically delineate the body of evidence pertaining to facilitators and barriers to the implementation of performance-based financing within the realm of healthcare provision in low- and middle-income nations.
Methods: The review used Preferred Reporting Items for Systematic Reviews and a Meta-Analysis extension for Scoping Reviews checklist to select, appraise, and report the findings. We searched PubMed, Web of Science, and Google Scholar databases and grey literature published between January 2000 and March 2022. We conducted the abstract screening with two independent reviewers. We also performed full-article screening. We used the six methodological frameworks proposed by Arksey and O'Malley. The results were thematically analyzed.
Results: Of the 1071 searched studies, 34 met the eligibility criteria. 41% of the studies were descriptive, 26% cross-sectional, 18% trial, and 15% cohort studies. The enabling and inhibiting factors of performance-based financing in healthcare delivery have been identified. Moreover, the review revealed that performance-based financing's influence on service delivery is context-specific.
Conclusion: The facilitators and impediments to the effectiveness of performance-based financing in enhancing service delivery are contingent upon a holistic comprehension of the contextual factors, meticulous design, and efficient execution. Factors such as the level of care facilities, presence of community-based initiatives, stakeholder involvement, and participatory design emerge as key facilitators. Conversely, barriers such as communication obstacles, inadequacies in the PBF models, and deficiencies in the healthcare workforce are recognized as inhibitors. By harnessing the insights derived from a multitude of evidence incorporated in this scrutiny, stakeholders can deftly navigate the intricacies of performance-based financing, while also considering the prospective areas for further exploration and research.. [Ethiop. J. Health Dev. 2024; 38(1): 00-00]
Keywords: Performance-based financing, healthcare delivery, Scoping review.
Registration: The scoping review protocol was not registered

Association of Harsh Physical Disciplining and the Mental and Behavioral Health Problems among Pre-School Children in Ethiopia

2024-03-07T01:10:03-05:00

Abstract Background: Harsh physical discipline may have an impact on the emotional and behavioral health and cognitive abilities of children and adolescents. There is little understanding of the association between harsh physical disci-pline and mental health issues in populations where harsh disciplinary measures are culturally normal.
Objective: The primary objective of this research was to investigate the potential correlation between the use of harsh physical discipline methods and the development of mental and behavioral health issues in children. By ex-amining the impact of these disciplinary practices on the psychological well-being of children, this study sought to shed light on the potential long-term consequences of such parenting strategies. Through a thorough analysis of data collected from a diverse sample of families, the researchers aimed to provide valuable insights into the effects of harsh physical disciplining on child mental health outcomes. Methods: A cross-section survey was conducted on 358 pre-school children preschool children and their primary caregivers in ten randomly selected elementary schools in Addis Ababa. The Strengths and Difficulties (SDQ) questionnaire was used to measure the mental and behavioral health of the children. The Parent-Child Conflict Tactics Scale measured the primary caregivers' experience of harsh physical discipline.
Result: The study found that more than two of the three primary caregivers witnessed the harsh physical discipline of pre-school children in their lifetime. The study also showed that the likelihood of having any of the mental or behavioral problems was higher among children who experienced harsh physical discipline. AOR = 5.8; 95% CI, 1.7, 17.4). It was also higher among preschool children in the second (AOR = 2.9; 95% CI, (1.2, 7.0)) order of birth and children perceived to have a moderate AOR = 5.0; 95% CI, (1.1, 23.4) and a lower AOR = 17.0; 95% CI, 17.0 (1.3, 218) school performance.
Conclusion This study has revealed a concerning connection between the physical discipline of preschool-aged children and the development of mental and behavioral health issues. The findings underscore the importance of policymakers and stakeholders in implementing interventions to prevent harsh verbal and physical discipline of young children. Society as a whole must prioritize the well-being and emotional health of our youngest members, and taking steps to promote positive and nurturing forms of discipline is essential in safeguarding their overall development and future success. [Ethiop. J. Health Dev. 2024; 38(1): 00-00]
Keywords: Physical discipline, mental/ behavioral health problem, preschool children

The Ethiopian Journal of Health Development

Factors Inhibiting and Enabling Performance-Based Financing in Health Care Delivery across Low and Middle-Income Countries: A Scoping Review

Association of Harsh Physical Disciplining and the Mental and Behavioral Health Problems among Pre-School Children in Ethiopia