Effects of Direct Healthcare Financing on Strategic Health Indicators in Rural Health Facilities of Chikankata District of Zambia: 2014 – 2018
Abstract
Healthcare financing is the process of utilizing financial inputs necessary for health interventions. Health facilities do not routinely access the monthly government grant due to challenges in the access and utilization process. It is unclear if the lack of grant receipt affects strategic health indicators and thus access quality healthcare provision in rural Zambia. This study aimed at investigating the effect of funding access on health facility performance. The study analyzed data for 15 health facilities in Chikankata district from 2014 to 2018. Data was collected from the health management information system and analyzed against accounting records to determine if facilities performed better in antenatal care, Immunization and Institutional deliveries when they received their monthly grants. Grant receipt had a statistically significant (p=0.04) association with performance in maternal and child health indicators, measured by a mean composite score OR 1.46, 95% CI [1.03, 2.08]. The association between grant receipt and indicator performance was most significant on institutional deliveries OR 1.75, 95% [1.13, 2.73]. Grant receipt by the facilities was associated with an improvement in maternal and child health indicators. This demonstrates the need for effective healthcare financing mechanisms that consider the monthly grant in improving performance by facilities. Performance Based Financing mechanisms should however be combined with direct financing mechanisms to holistically improve primary healthcare. The implications of these findings are that as much as practical, funding disbursement modalities must ensure that all health facilities receive some funding.All authors who submit their paper for publication will abide by following provisions of the copyright transfer: 1. The copyright of the paper rests with the authors. And they are transferring the copyright to publish the article and used the article for indexing and storing for public use with due reference to published matter in the name of concerned authors. 2. The authors reserve all proprietary rights such as patent rights and the right to use all or part of the article in future works of their own such as lectures, press releases, and reviews of textbooks. 3. In the case of republication of the whole, part, or parts thereof, in periodicals or reprint publications by a third party, written permission must be obtained from the Managing Editor of JPRM. 4. The authors declare that the material being presented by them in this paper is their original work, and does not contain or include material taken from other copyrighted sources. Wherever such material has been included, it has been clearly indented or/and identified by quotation marks and due and proper acknowledgements given by citing the source at appropriate places. 5. The paper, the final version of which they submit, is not substantially the same as any that they had already published elsewhere. 6. They declare that they have not sent the paper or any paper substantially the same as the submitted one, for publication anywhere else. 7. Furthermore, the author may only post his/her version provided acknowledgement is given to the original source of publication in this journal and a link is inserted wherever published. 8. All contents, Parts, written matters, publications are under copyright act taken by JPRM. 9. Published articles will be available for use by scholars and researchers. 10. IJPRM is not responsible in any type of claim on publication in our Journal. .