Effectiveness of Performance-Based non-Financial Incentive for Improved Health Data Quality and Information Use at Primary Health Care Units, Northwest Ethiopia

Abstract

Abstract
Introduction: Several internal and external factors in the health system pose challenges to the quality and use of health data. One of the behavioral and moral variables that can impact data quality and information use practices is the motivation of the health workforce. A performance-based non-financial incentive intervention was put into place in primary healthcare units of rural districts.
Objective: This research aimed to measure the effectiveness of PBNI intervention on data quality and information use in rural districts of primary healthcare units in Northwest Ethiopia.
Methods: Quasi-experimental design using a facility-based survey was employed to form groups of incentivized and non-incentivized health facilities. The study was conducted in the Wogera and Tach-Armacheho districts, which were the intervention and control districts. Awards, certifications, scholarships, and promotions for the best-performing individual, department, or health facility were provided as an incentive. The proportion and mean of the characteristics of participants were presented descriptively, and a difference in difference analysis was conducted to measure the effectiveness of PBNI on data quality and information use.
Results: A total of 84 and 90 departments were included in the base-line and end-line in Wogera (Intervention) and control (Tach-Armacheho) districts respectively. Wogera district had 40 (47%) and 44 (48.89%) departments included during the base-line and end-line periods. In the Wogera district, the average Level of data quality increased from 15% baseline at month 1 to 25% endline at month 2. In tach armacheho, however, the quality dropped from 11.7% at the start to 9.2 at the end. Evidence on using available information to inform decision-makers was found in 36% and 28% at the base-line and 50% and 60% in the end-line assessment in Tach Armachiho and Wogera districts, respectively. The average mean Difference in information use between intervention and control groups was 30.4 percentage points (p-value=0.008) between the end line and base-line assessments. The Difference in information use change in the intervention district compared to its counterpart was 25, at 95 % CI [2%, 47%] percentage points, P-value =0.003.
Conclusion: Performance-based non-financial incentive has significantly changed the health data quality and information use in the intervention site. Thus, scaling up the intervention to other similar contexts is essential. [Ethiop. J. Health Dev. 2023;37 (SI-1)]
Keywords: Performance-based financing, data quality, information utilization, Amhara, Ethiopia