Towards sustainability of RBF in the health sector – learning from experience in high and middle income countries

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Results based financing (RBF) approaches have grown in number, geographical coverage and type over the past 15 years in low and middle income countries (LMICs). They remain however largely dependent on external support, financial and technical, and to a large extent operating as parallel programs. The aim of this paper was to draw on experiences from possibly more developed RBF schemes in middle and high income countries (HICs) in order to provide guidance for the future in LMIC settings. RBF in this paper focused on supply-side approaches, so excluding strategies such as conditional cash transfers. Sustainability was defined in relation to four main domains: de facto, financial, institutional and social/political/technical.