Implementation Outcomes of Performance Based Non-financial Incentive: using RE-AIM framework

Background: Quality health data production is vital for effective evidence-based decision-making in the health-care industry. Several factors challenge using complete and timely health data in practice. This study evaluated how the Performance-Based None-financial Intervention (PBNI) intervention was reached, effective, adapted, implemented as per the protocol, and able to sustain in the contextual environment using RE-AIM framework. Aim: The study aimed to evaluate the implementation outcomes of PBNI with the coverage (reach), effectiveness, adoption, implementation, and maintenance of the intervention. Methods: The intervention was implemented in Wogera district, northwest Ethiopia. The study used a mixed study design. The quantitative component has a quasi-experimental study design to assess the change in data use due to PBNI. The qualitative component has a phenomenological design to assess the lived experience of participants. The coverage (reach) and effectiveness of PBNI intervention were assessed with descriptive statistics. Key informant interviewees were used to evaluate the adoption, implementation, and maintenance of the PBNI implementation. The coverage and effectiveness of the intervention were assessed using proportions and numbers. Thematic analysis was employed to analyze the qualitative data. Results: A total of 13 participants were involved in the qualitative assessment. Concerning the reach of PBNI, all (six) health centers, all (i.e., 42) departments, and all health workers in the six health centers were covered. Regarding its effectiveness, the data use has resulted in percentage changes of 31% (p-value < 0.001). Concerning the adoption of PBNI, the health management information system focal person confirmed that their health facilities would implement it even after the completion of the project. The implementers were consistently communicating, evaluating performance, and intervening consistently throughout the intervention period, showing the implementation's fidelity. The finding indicated that sustaining PBNI intervention needs strong governmental commitment and active HIS leaders to improve quality health data production and use. Conclusion: The coverage of PBNI, the intervention's effectiveness, and the implementation's adoption were promising. Moreover, there was a conducive environment at the individual, case-team, and facility levels to sustain PBNI. However, long-lasting sustainability would depend on the commitment of the i