Results-Based Financing’s Impact on Human Resources for Health in Zambia

Results-based financing (RBF) has been implemented in low- and middle income countries with the aim of transforming health systems and achieving Millennium Development Goals 4 and 5. However, there is a dearth of empirical evidence on the impact of RBF-facility financing and provider incentives on performance related factors such as health workers  satisfaction, motivation, productivity, and retention. This paper attempts to fill such gap by examining the relationship between RBF and health care practitioner outcomes through the case of Zambia. It uses a cluster randomized intervention/control design to evaluate before–after changes for three groups: one that received pay for performance, a counterfactual group that received additional financing not conditioned on performance, and another counterfactual group that received no enhanced financing.