Implementation strategies to performance-based non-financial incentive intervention for better data quality and use: the case of resource-limited settings, Northwest Ethiopia

Background: Evidence showed that incentive motivates health workers and improves health-related data quality and use. However, proven interventions, including incentives, may not always improve data quality and use due to context differences. In this regard, how performance-based non-financial incentive (PBNI) improves health -related data quality and use is unclear in Ethiopian settings.Objective: The study aimed to develop strategies for implementing PBNI to improve health-related data quality and information use in northwest Ethiopia. Methods: The study was implementation research that employed a qualitative design to improve data quality and information use among individuals, departments, and health centers through PBNI intervention. It was conducted in Wogera district, northwest Ethiopia, between October 2020 and July 2021. First, potential barriers and facilitators of implementing PBNI were identified through discussion meetings, observations, and interviews. Then, potential strategies that were helpful to overcome the barriers and capitalize on opportunities were identified and implemented in an iterative and tailored manner for six months until data quality and information use were sufficiently improved cost-effectively.Results: The use of multi-layered methods to measure the performance of potential awardees and the creation and regular use of the data-day platform to recognize best performers and make constructive discussions about health -related data quality and use with higher officials were some strategies employed in the implementation research. The other strategies employed were also to show the performance evaluation process and results of health workers transparently and publicly during the data-day and reaching out to all potential awardees fairly and equally when there was important information to communicate. In addition, utilizing the culture of transparent, professional, and constructive peer-to-peer criticism among staff members during the review meetings and data-days and building their trust in the research team were a few strategies employed and resulted in improved data quality and use.Conclusions: The improved health-related data quality and information use after implementing PBNI with a reasonable cost was the effect of utilizing strategies mentioned in the results section through the data-day platform, transparent and multi-layered performance evaluation methods, and the strong directive messages from higher officials during the data-day take the lions share.