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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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Pay-for-performance in resource-constrained settings: Lessons learned from Thailand’s Quality and Outcomes Framework

In 2010, Thailand introduced the first pay-for-performance (P4P) programme, called on-top payment, in order to reduce variations in quality and accessibility of care provision by encouraging CUPs to improve infrastructure and staffing. Since this programme was criticized for not clearly contributing to the quality of services and health outcomes, it was replaced by the Quality […]
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Contribution to Improving the Quality of Care: the Case of Burkina Faso

The pilot Results-Based Financning (RBF) project in Burkina Faso was launched on 26 December 2013. RBF purchases health worker results.  It pays subsidies for the quantity of services provided and provides a bonus for the quality of care, which is assessed at facility and community levels.  In this context, RBF differs from traditional financing strategies whereby the […]
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Can We Expect Results-Based Financing to Improve Quality of Care?

Results-Based Financing (RBF) schemes in healthcare are premised on the notion that “paying for results” rather than for inputs is more likely to improve performance. But getting from that attractive hypothesis to program efforts that improve quality of care and outcomes at population scale—in the real world—is far from simple. The article offers an overview […]
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Coming Full Circle: How Health Worker Motivation and Performance in Results-Based Financing Arrangements Hinges on Strong and Adaptive Health Systems

This paper presents findings from a study which sought to understand why health workers in the results-based financing (RBF) arrangements in Zimbabwe reported being satisfied with the improvements in working conditions and compensation, but paradoxically reported lower motivation levels compared to those not working under RBF arrangements.
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