Effect of Performance-based Financing on the Coverage of Antenatal Care and Immunization Services in Buea Health District, Cameroon

Abstract

Introduction and Aim: Financing healthcare is a major factor in our society today which affects access to quality healthcare. The MDGs reached their deadline in 2015 but progress has been insufficient with reducing the morbidity and mortality rates of diseases. The healthcare system of Cameroon is characterized by low coverage for preventive care services. Innovative ways must be identified to fast track the coverage of MCH services. Lack of incentives affects the coverage of ANC and immunization services. The aim of this study was to assess the effect of PBF on the coverage of ANC and immunization services. Methods: An experimental study design was used and health facilities in the Buea Health District were randomly selected and assigned to one of four groups, three intervention groups (T1, C1 and C2) and one control group (C3). Using multistage sampling, a total of 434 postpartum mothers and 474 children participated in the study. An interviewer administered questionnaire was used and data was analyzed using EPI Info version 3.5.4 and STATA version 10.1 statistical software. Results: The mean age of the 434 postpartum mothers was 26.03. Supervision alone had significant effect on the four or more ANC visits (p=0.04). Both financing and supervision had statistically significant effect on the four or more ANC visits (p=0.003) and immunization. Financing and fixed per capita budgetary supplement did not have a significant effect on the coverage of ANC and immunization services. Conclusion: Both Financing and enforced supervision is necessary in order to improve the coverage of ANC and immunization services thus accelerating progress towards improving MCH.