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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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Financial Incentives For Maternal Health: Impact of a National Programme in Nepal

Financial incentives are increasingly being advocated as an effective means to influence health-related behaviours. There is, however, limited evidence on whether they work in low-income countries, particularly when implemented at scale. This paper explores the impact of a national programme in Nepal that provides cash incentives to women conditional on them giving birth in a […]
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Policy Paper: Payment by Results Strategy: Sharpening Incentives to Perform

DFID is increasingly making use of Payment by Results. As the number of programmes grows, DFID needs a consistent approach and a clear way forward. This strategy sets out our objectives for the use of Payment by Results and the actions we will take to achieve these. Section 1 outlines the background to Payment by […]
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Plan Nacer: Enabling a Health Start for Babies Born into Poverty

In 2004, Government of Argentina launched Plan Nacer, supported by an adaptable loan from the World Bank (US$135.8 million). Plan Nacer provided a free basic package of cost-effective services to women and children through participating healthcare providers in the country’s nine poorest provinces. In 2006, the Program was expanded to the remaining fourteen provinces with […]
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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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Improving Health Worker Performance: The Patient-Perspective from a PBF Program in Rwanda

Over recent decades, paying healthcare providers against agreed performance targets has gained momentum in high income countries and more recently in low and middle income countries (LMIC). Poor performance in health systems is a worldwide concern and greater investment in the health sector do not necessarily translate to better health outcomes (World Health Organization, 2000). […]
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