Introduction: The increased use of results-based financing (RBF) services was the basis for this study designed to evaluate the contribution of RBF to the capacity of response of the health system to the population’s expectations. Methods: This study, conducted in six Benin health zones randomly selected in two strata exposed to RBF (FBR_PRPSS and FBR_PASS) and one zone not exposed to RBF (Non_FBR), examined the seven dimensions of reactivity. A score, followed by weighting of their attributes, was used to calculate the index of reactivity (IR). Results: Sixty-seven health care units and 653 people were observed and interviewed. The FBR_PRPSS and FBR_PASS strata, managed by the new provisions of RBF, displayed good performances for the “rapidity of management” (70% and 80%) and “quality of the health care environment” dimensions, with a more marked improvement for the PRPSS model, which provides greater resources. Poor access to social welfare networks in the three strata led to renouncing of health care. The capacity of response to expectations was moderate and similar in the Non_FBR (IR = 0.53), FBR_PASS (IR = 0.62) and FBR_PRPSS (IR = 0.61) strata (p > 0.05). Conclusion: The FBR_PRPSS and FBR_PASS models have a non-significant effect on the capacity of response. Their success probably depends on the health system context, the combination of targeted interventions, such as universal health insurance, but also the importance and the use of the new resources that they provide.
Keywords: results-based financing; performance; capacity of response; health system; reactivity; Benin.