Pay-for-Performance for Improved Health In Burundi

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About this resource

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 (measured partially through patient and community satisfaction) and a degree of facility-level autonomy to determine what to invest in and how to share payments among staff. This case study describes the P4P pilot scheme in Burundi, how the pilot influenced design of nationwide scale-up of P4P, and offers lessons for countries that are considering implementing similar government-led nationwide schemes.

From the Health System 20/20 P4P case study series, which profiles maternal and child health-oriented P4P programs in countries in Africa, Asia, and the Americas, and is intended to help those countries and donors already engaged in P4P to fine-tune their programs and those that are contemplating P4P to adopt such a program as part of their efforts to strengthen their health system and improve health outcomes.