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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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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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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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Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia

Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of ‘internal contracting’ for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This […]
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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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