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Burundi: Questions on the Financial Sustainability of Performance-Based Financing and Free Health Care

This document focuses on the financial sustainability of the strategy linking performance-based financing (PBF) and free health care (FHC) implemented nationwide in Burundi since 2010. It examines the financial resources invested by the government and its technical and financial partners to establish whether government resources alone can guarantee the financial sustainability of PBF-FHC or whether […]
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Using Performance Incentives to Improve Medical Care Productivity and Health Outcomes

In this paper we provide evidence on the effect of incentives on provider productivity and on health outcomes in Rwanda, where we nested a prospective field experiment into the national rollout of a P4P incentive scheme. P4P affects health care provision in two ways; first, through incentives for providers to expend more effort in specific […]
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Innovative Financing for Health in Rwanda: A Report of Successful Reforms

Rwanda has been moving very rapidly to expand health service delivery. It has dramatically accelerated the trend of progress on health indicators, putting it back on track to reach the health Millennium Development Goals (MDGs). Three interrelated innovative reforms contributed to improvement: community-based health insurance, performance-based financing within a broader framework of reform of management […]
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The Application of Social Impact Bonds to Universal Health-Care Initiatives in South-East Asia

Social impact bonds (SIBs) have the potential to improve the efficiency of government health-care spending in South-East Asia. In a SIB, governments sign a pay-for-performance contract with one or several providers of health-care services, and the providers borrow up-front capital from investors. Governments outside South-East Asia have started to experiment with SIBs in criminal justice, homelessness and health care. Governments […]
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Pay-for-Performance for Improved Health In Burundi

To increase utilization of health services and improve maternal and child health outcomes, Burundi is in the process of rolling out a publicly funded supply-side pay-for-performance (P4P) program nationwide consisting of payments to health facilities. Interesting features of this program include use of monthly quantity-related incentive payments (based on service utilization) and quarterly quality-related payments […]
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(How) does RBF strengthen strategic purchasing of health care? Comparing the experience of Uganda, Zimbabwe and the Democratic Republic of the Congo

Results-Based Financing (RBF) has proliferated in health sectors of low and middle income countries, especially fragile and conflict-affected ones, and has been presented as a way of reforming and strengthening strategic purchasing. However, few studies have empirically examined how RBF impacts on health care purchasing in these settings. This article examines the effects of several […]
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Performance-Based Financing (PBF) - The Forest, Not the Tree!

This presentation conveys information on how PBF is much more than a provider payment mechanism. It offers an opportunity for wider reforms. PBF can be a means: for greater accountability and responsiveness for health outcomes / technical efficiency to more allocative efficiency a means to health equity to resource mobilisation for health to public sector […]
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