Effect of results based financing on utilization of maternal health services in Kamuli district

Abstract

This study examined the effect of Result Based Financing on utilization of maternal healthcare services (4&+ ANC attendance and facility delivery) in Kamuli District. Result Based financing approach has proved to have the potential to increase the utilization of maternal health services elsewhere and this was the reason why this study was done in Uganda. Data was collected from an Intervention district (Kamuli) and Control district (Iganga).The study comprised 380 respondents of women of reproductive age (15-49) who had given birth 12 months preceding the study. Following a multivariate analysis using particularly a binary logistic regression model, the study shows that Results Based Financing was not a statistically significant variable influencing Utilization of Maternal Health Services as the proportion of mothers Utilizing maternal health care services in an intervention district (Kamuli) was not significantly different from that in the control district (Iganga). On the contrary factors that were associated with utilization of maternal healthcare services included; Age i.e. higher for middle ages (25-29) as compared to other ages , Occupation (formal employment/trade as opposed to other occupation categories ), Education (Tertiary and not less levels ) and Religion (Protestants and Muslims as opposed to Catholics and other religions) ). RBF was found not to have had an impact due to the following reasons raised by health workers; Low Salary for health workers and hence low morale, increased workload for the few heath workers in the stations, unfairness in distribution of bonuses and most supervisors leaving work for the lower cadres and yet bonuses were not enough to make health workers meet their basics. As a recommendation, Government should increase salary for health workers to motivate them; there should be fairness in distribution of bonuses and mass sensitization of all stakeholders should be done to enhance local ownership, involvement and sustainability for such initiatives.