 Our study found that health worker's knowledge of, satisfaction with, and perceptions of performance-based financing, PBF, vary significantly across facilities in Burkina Faso. This heterogeneity was associated with various factors such as responsibility at the facility, general work attitudes, management factors, and training in and length of exposure to PBF. Investments into staff training on PBF and manager training on organizational change processes could potentially improve staff attitudes toward PBF, leading to improved effectiveness of PBF. This article was authored by Julia Lohman, Jean-Louis Collidiotti, Serge M. Asamda, and others.