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A performance-based financing (PBF) pilot project was implemented in 2011 in Burkina Faso. After more than five years of implementation (data collection in 2016), the project's sustainability was not guaranteed. This study's objective is to assess this project's sustainability in 2016 by identifying the presence/absence of different determinants of sustainability according to the conceptual framework of Seppey et al. (2017).

It uses a case study approach using in-depth interviews with various actors at the local, district/regional and national levels. Participants (n = 37) included health practitioners, management team members, implementers and senior members of health directions. A thematic analysis based on the conceptual framework was conducted, as well as an inductive analysis.

Results show the project's sustainability level was weak according to an unequal presence of sustainability's determinants; some activities are being maintained but not fully routinised. Discrepancies between the project and the context's values appeared to be important barriers towards sustainability. Project's ownership by key stakeholders also seemed superficial despite the implementers' leadership towards its success. The project's objective towards greater autonomy for health centres was also directly confronting the Burkinabe's hierarchical health system.

This study reveals many fits and misfits between a PBF project and its context affecting its ability to sustain activities through time. It also underlines the importance of using a conceptual framework in implementing and evaluating interventions. These results could be interesting for decision-makers and implementers in further assessing PBF projects elsewhere.

The purpose of this study is to evaluate the contribution of the business climate on the sustainability of Cameroonian small- and medium-sized enterprises (SMEs) in times of coronavirus disease 2019 (COVID-19).

To achieve this purpose, the study proceed with a quantitative analysis using the simple LOGIT model on a sample of 52 individuals.

Through the administration of questionnaires and estimations, results reveal that certain variables such as the taxation regime of the enterprise, the different types of taxes paid by the enterprise, the frequency of payment of income tax, the nature of the training of managers, the clauses of the debt contracts with banks/EMFs (Microfinance institution), the time taken to apply for a loan from the bank and the nature of the manager’s training have a negative influence on the sustainability of Cameroonian SMEs during COVID-19, while others such as the evolution of financial profitability in the context of the coronavirus pandemic in Cameroon, the company’s sector of activity and the main methods of financing the SME have a positive influence on the sustainability of Cameroonian SMEs during COVID-19 pandemic. The improvement of the business climate by the institutional authorities is, therefore, essential in the perspective of an eventual development of the country; the said development cannot take place without capitalizing on the potential for income and job creation by SMEs.

The first limitation is related to the size of the sample and also to the specificity of our study. In fact, the study is conducted among individuals/actors likely to have access to information on the business climate and sustainability of Cameroonian SMEs at the time of COVID-19 encountered in the city of Yaoundé. In this context, the sample size is considered to be small (52). This element does not immediately allow the results of the present research to be generalized to all regions where SMEs are located in Cameroon, as other criteria or other elements must still be taken into account and the results obtained must, therefore, be interpreted with caution. This research could be deepened in the future by considering more business climate variables on the one hand and a larger sample size extended to all cities in Cameroon on the other.

The results of this research confirm the importance of institutional bodies establishing a rigorous policy of support for businesses. Such a policy would contribute to improving the business climate and extend beyond mere resilience.

The originality of this study lies in the fact that it looks at the sustainability of SMEs in the context of the COVID-19 pandemic in Cameroon using a simple LOGIT econometric model.