Cost-effectiveness of Performance-based Non-financial Incentive (PBNI) intervention to improve health information system performance at Wogera District in Northwest Ethiopia

Abstract

AbstractIntroduction: Several behavioral and moral factors influence health information use and practice, including healthcare motivation. A performance-based non-financial incentive (PBNI) intervention was developed to improve the quality of data and information use practices in the Wogera district.Objectives: This research aimed to assess the cost-effectiveness of PBNI interventions to improve data quality and information use practices in Northwest Ethiopia.Methods: In the northwest Ethiopian districts of Wogera (the intervention site) and Tach-Armachiho (the comparison site), a quasi-experimental study was carried out. The study included health centers, departments, and health professionals. Six health centers and health professionals working at the health centers were included. PBNI intervention, including different motivation packages, was implemented at Wogera district health facilities. Before and following the intervention, the Wogera and Tach-Armachiho districts' performance in terms of health information was evaluated. The cost of the intervention was estimated using an activity-based, bottom-up approach. Calculations were made to determine the incremental cost-effectiveness and average cost-effectiveness ratio.Result: The study enrolled eighty-six study departments. Of these, 42 (48.8%) were from Wogera district. In comparison to the comparative group's 52,078 ETB, the average cost-effectiveness ratio for the PBNI intervention was 20,970 ETB per unit percentage improvement in HIS performance. But the incremental cost-effectiveness ratio (ICER) for PBNI intervention showed 10,600.5 ETB/percentage point HIS performance improvement.Conclusion: The performance of the health information system in healthcare institutions was improved through the integration of PBNI with implementation packages for health information. Therefore, PBNI should be designed as one motivational strategy by the health institutions to incentivize health providers to improve data quality and evidence-based decision-making with limited resources. [Ethiop. J. Health Dev. 2023;37 (SI-1)]Keywords: Health information system, performance-based non-financial incentive, CEA, ICER