Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

The low quality of healthcare and the presence of user fees in Burkina Faso contribute to low utilization of healthcare services and high levels of mortality. To improve access to high quality healthcare, national authorities have implemented an intervention that combines performance-based financing (PBF) with social protection strategies. However, the body of evidence on the implementation and effectiveness of PBF is not well established. There is an urgent need to examine if this intervention causes unintended effects. The objectives of this study will be 1) to conduct a systematic review of the literature on the unintended effects of PBF in low-income countries, 2) to determine, from empirical data, whether the different components of the intervention resulted in unintended effects and 3) to identify adaptation strategies to improve the intervention. We will use multiple sources of quantitative and qualitative data (e.g., interviews, observations, administrative data). The results of this study will help the global health community understand the unintended effects resulting from this complex intervention to improve the health of the population.