Implementation of Performance-Based Budgeting for Public Health Care Service Delivery in an Emerging Economy

This study investigates the determinants and implications of the implementation of performance-based budgeting (PBB) on public health care service delivery at the Ministry of Health and Social Services (MoHSS) in Windhoek, Namibia. Using a cross-sectional survey research design targeting 100 respondents, this study employed a quantitative research approach involving MoHSS's budgeting and health care services departments. Data were analysed using partial least squares structural equation modelling. Communication, bureaucratic structures, and implementers’ disposition significantly influenced PBB implementation alignment, thereby enhancing service delivery. However, resource utilisation showed no significant effect. Additionally, implementation alignment effectively mediated the relationship between latent exogenous variables and service outcomes. Therefore, strengthening communication, optimising bureaucratic structures, and enhancing resource management strategies are essential for successful PBB implementation at the MoHSS in Windhoek. This study provides empirical insights into the relationship between PBB practices and public service delivery within an emerging economy's healthcare context.