Catalyzing Maternal and Child Health Results by Paying for Performance: Evidence from Developing Countries. Catherine Connor and Rena Eichler Health Systems 20/20 Project. 15 November 2010 Health Systems Research Symposium. Feasibility of Insurance Design and Implementation .
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Catherine Connor and Rena Eichler
Health Systems 20/20 Project
15 November 2010
Health Systems Research Symposium
Feasibility of Insurance Design Performance: Evidence from Developing Countriesand Implementation
Monitoring and EvaluationWhat does pay for performance have to do with reaching universal coverage?
Pay providers for quality or efficiency
Incentives to use priority services
Incentives to cover hard-to-reach populations
What is Pay for Performance?
Highlights from on-line survey of country experiences
Expanding access for maternal and child health results: the case of Burundi
What we mean by P4P Performance: Evidence from Developing Countries
Donars. Govenment, NGOs
Health Programs, Insurers
Funds, Goods, Other
Patients or Families
Service Providers (facility or health worker)
NGO or program implementer
Government - Local or National
Many terms: results-based financing, performance-based financing, performance-based contracting, conditional cash transfers, …
One common definition:
*From the Center for Global Development Working Group on Performance-Based Incentives
Why is P4P getting so much attention? Performance: Evidence from Developing Countries
Why do this survey?
To fill the gap between growing experimentation and little documentation
Global online survey 2009
25 responses summarized
14 longer case studies in 2010
Maternal health results dominate (22/25).
Child health results also top priority (14/25).
Infectious (e.g. HIV/AIDS, malaria) and non-communicable diseases (e.g. cancer screening, diabetes and asthma management) included but less frequent
Primary care facilities Performance: Evidence from Developing Countries
Rural or peri-urban areas
Demand side (users/patients) - vouchers and transportation subsidies
Increasing attempts to reward quality
Survey results: Designs to expand access
BURUNDI Performance: Evidence from Developing CountriesPublic-private purchasing to increase use of priority services and improve quality
1. Kaneza 2007; 2.http://healthsystems2020.healthsystemsdatabase.org/
P4P Purchasing – how it works Performance: Evidence from Developing Countries
Monthly payments fee for service
quarterly bonus for quality
Burundi Results – Kibuye Province
Reports related to this presentation
are available at www.HS2020.org