Table 7.

Comparison of high- and low-performing CSCOMs by CFIR domains and constructs

Domain	CFIR construct	High-performing CSCOMs	Low-performing CSCOMs
Internal context	Implementation climate:	Perception that the CSCOMs had prepared well for PBF implementation	Staff of some CSCOMs reported that the conditions required to start the PBF were not met due to lack of equipment and infrastructure
	- Tension around change
	Implementation climate:	Objectives set out in the contract were, in many cases, discussed before being ratified	The objectives were hardly discussed with the rest of the staff
			Results plans were seldom shared with the rest of the staff
	- Objectives and feedback	Briefing sessions were used to communicate the objectives in the results plans
	Implementation climate: - A learning environment	Awareness of being a single team in which each member is personally responsible for the outcomes Stronger collective commitment
	Readiness for implementation:	TDCs explained the data on the importance of PBF to the rest of the staff to motivate them	Weak leadership of TDCs; often conflictual interactions with the ASACO
	- Leadership engagement
Process	Engaging	Many awareness-raising activities conducted by a team consisting of the TDC, the commune mayor and the ASACO chairman	TDCs led most of the awareness-raising sessions on their own

ASACO Association de santé communautaire (community health association), CFIR Consolidated Framework for Implementation Research, CSCOM Community health centre, PBF performance-based financing, TDC Technical Director of the Centre