Proportion of Health Facility Expenditures Allocated to the Payment of Financial Incentives in a Performance-Based Financing Program: A Case Study of Six Health Facilities and Four District Hospitals in the Koulikoro Region of Mali

This study examines the effects of using special quality improvement bonuses (Special Quality Improvement Bonuses) as a strategy to address health inequalities and accelerate universal health coverage under a results-based financing model. The authors present a case study of a health facility located in a vulnerable and insecure area that received such a bonus, highlighting the positive impact on infrastructure, equipment, staffing and service delivery. The study highlights the effectiveness of these bonuses in improving the quality of health services and bringing quality of care closer to vulnerable populations. More specifically, these incentives enabled health facilities to upgrade their technical platform (infrastructure, equipment, technical staff), thereby enabling them to implement the minimum package of activities. In addition, these bonuses, which had been awarded on the basis of the level of the technical level, were intended to correct inequalities between competing health facilities, thereby further improving the staffing and service delivery capacities of these structures.