title: Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso.
abstract: BACKGROUND
  One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs) also referred as performance-based financing. Our study aims to explore healthcare providers' preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District.
  
  
  METHODS
  A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels.
  
  
  RESULTS
  Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]). Most health workers (95 and 96%) expressed a preference for financial incentives (95% CI: [66.64; 85.36]) and team-based incentives (95% CI: [67.78; 86.22]), respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization.
  
  
  CONCLUSIONS
  The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes.
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso; yemaure@yahoo.fr.
authors.forename: Maurice
authors.initials: M
authors.lastname: Yé
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Eric
authors.initials: E
authors.lastname: Diboulo
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Moubassira
authors.initials: M
authors.lastname: Kagoné
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Ali
authors.initials: A
authors.lastname: Sié
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Sauerborn
authors.affiliation: Department of General Practice and Health Services Research, University of Heidelberg Hospital, Heidelberg, Germany.
authors.forename: Svetla
authors.initials: S
authors.lastname: Loukanova
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002050:Burkina Faso; D005260:Female; D005102:Health Expenditures; D006282:Health Personnel / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D012052:Reimbursement, Incentive; D012423:Rural Health / Q000191:economics*; D011795:Surveys and Questionnaires
keywords: Burkina Faso; child health; healthcare providers; maternal health; motivation; pay for performance; performance-based financing; performance-based incentive