Paying Primary Health Care Centers for Performance in Rwanda

Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the am...

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Main Authors: Basinga, Paulin, Gertler, Paul J., Soucat, Agnes L.B., Binagwaho, Agnes, Sturdy, Jennifer R., Vermeersch, Christel M.J.
Format: Policy Research Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2014
Subjects:
HIV
SEX
STD
Online Access:http://documents.worldbank.org/curated/en/2010/01/11696987/paying-primary-health-care-centers-performance-rwanda
http://hdl.handle.net/10986/19900
id okr-10986-19900
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic ALCOHOL
ALCOHOL USE
ANEMIA
ANTENATAL CARE
BLEEDING
BODY WEIGHT
CHILD GROWTH MONITORING
CHILD HEALTH
CHILD HEALTH CARE
CHILD HEALTH SERVICES
CHILD SURVIVAL
CHILDBIRTH
CLEANLINESS
CLINICAL PRACTICE
CLINICS
COMMUNITY HEALTH
COMMUNITY HEALTH WORKERS
CONTRACEPTIVE USE
CONTRACEPTIVE USERS
DEVELOPING COUNTRIES
DIABETES
DISTRICT HOSPITAL
DRUGS
EMPOWERING WOMEN
EXPENDITURES
FAMILIES
FAMILY MEMBERS
FAMILY PLANNING
FINANCIAL MANAGEMENT
GENOCIDE
GLOBAL DEVELOPMENT
GLOBAL HEALTH
GOITER
GONORRHEA
GRID
HEALTH BEHAVIOR
HEALTH CARE CENTERS
HEALTH CARE SERVICES
HEALTH CENTERS
HEALTH CENTRES
HEALTH FACILITIES
HEALTH FACILITY
HEALTH FINANCING
HEALTH INSURANCE
HEALTH INTERVENTIONS
HEALTH OUTCOMES
HEALTH POLICY
HEALTH PROBLEMS
HEALTH SERVICES
HEALTH SYSTEM
HEALTH WORKERS
HEART DISEASE
HIGH BLOOD PRESSURE
HIV
HOSPITAL
HOSPITALS
HUMAN DEVELOPMENT
IMMUNIZATION
INCOME
INFANT
INFANT MORTALITY
INFANTS
INFORMED CONSENT
INTERVENTION
LAB TESTS
LABORATORY SERVICES
LAND OWNERSHIP
LOW BIRTH WEIGHT
LOW-INCOME COUNTRIES
MALARIA
MALARIA PROPHYLAXIS
MALNOURISHED CHILDREN
MARITAL STATUS
MATERNAL AND CHILD HEALTH
MATERNAL CARE
MATERNAL HEALTH
MATERNAL HEALTH SERVICES
MATERNAL MORTALITY
MEDICAL CARE
MEDICAL DOCTORS
MEDICAL PERSONNEL
MEDICAL SUPPLIES
MINISTRY OF HEALTH
MISCARRIAGES
MORBIDITY
MORTALITY
MOSQUITO NETS
MOTHER
NATIONAL HEALTH
NAUSEA
NEWBORN
NUMBER OF CHILDREN
NURSES
NUTRITION
OBSTETRIC CARE
OFFICIAL DEVELOPMENT ASSISTANCE
PAP SMEAR
PATIENT
PATIENTS
PHARMACY
PHYSICAL EXAMINATIONS
PHYSICIAN
PHYSICIANS
POLICY IMPLICATIONS
POLICY RESEARCH
POLICY RESEARCH WORKING PAPER
POPULATION DENSITY
POSTNATAL CARE
PREGNANCIES
PREGNANCY
PREGNANT WOMEN
PRENATAL CARE
PRENATAL CARE UTILIZATION
PREVENTIVE HEALTH
PREVENTIVE HEALTH CARE
PRIMARY CARE
PRIMARY EDUCATION
PRIMARY HEALTH CARE
PRIMARY HEALTH CARE FACILITIES
PROBABILITY
PROGRESS
PROPHYLAXIS
PUBLIC HEALTH
QUALITY CARE
QUALITY OF CARE
QUALITY OF HEALTH
QUALITY OF SERVICES
RATES OF GROWTH
REDUCING MATERNAL MORTALITY
RISK PREGNANCIES
RURAL AREAS
SAFE MOTHERHOOD
SERVICE DELIVERY
SERVICE PROVISION
SEX
SKILLED ATTENDANCE
SKILLED ATTENDANCE AT DELIVERY
SKILLED ATTENDANTS
SOCIAL RESEARCH
SOCIOECONOMIC STATUS
STD
STIS
SYMPTOMS
SYPHILIS
TETANUS
TOBACCO
TREATMENT
TROPICAL MEDICINE
TUBERCULOSIS
VACCINATION
VACCINATION CAMPAIGN
VACCINE
VACCINES
VITAL SIGNS
VOMITING
WOMAN
WORKERS
YOUNG CHILDREN
spellingShingle ALCOHOL
ALCOHOL USE
ANEMIA
ANTENATAL CARE
BLEEDING
BODY WEIGHT
CHILD GROWTH MONITORING
CHILD HEALTH
CHILD HEALTH CARE
CHILD HEALTH SERVICES
CHILD SURVIVAL
CHILDBIRTH
CLEANLINESS
CLINICAL PRACTICE
CLINICS
COMMUNITY HEALTH
COMMUNITY HEALTH WORKERS
CONTRACEPTIVE USE
CONTRACEPTIVE USERS
DEVELOPING COUNTRIES
DIABETES
DISTRICT HOSPITAL
DRUGS
EMPOWERING WOMEN
EXPENDITURES
FAMILIES
FAMILY MEMBERS
FAMILY PLANNING
FINANCIAL MANAGEMENT
GENOCIDE
GLOBAL DEVELOPMENT
GLOBAL HEALTH
GOITER
GONORRHEA
GRID
HEALTH BEHAVIOR
HEALTH CARE CENTERS
HEALTH CARE SERVICES
HEALTH CENTERS
HEALTH CENTRES
HEALTH FACILITIES
HEALTH FACILITY
HEALTH FINANCING
HEALTH INSURANCE
HEALTH INTERVENTIONS
HEALTH OUTCOMES
HEALTH POLICY
HEALTH PROBLEMS
HEALTH SERVICES
HEALTH SYSTEM
HEALTH WORKERS
HEART DISEASE
HIGH BLOOD PRESSURE
HIV
HOSPITAL
HOSPITALS
HUMAN DEVELOPMENT
IMMUNIZATION
INCOME
INFANT
INFANT MORTALITY
INFANTS
INFORMED CONSENT
INTERVENTION
LAB TESTS
LABORATORY SERVICES
LAND OWNERSHIP
LOW BIRTH WEIGHT
LOW-INCOME COUNTRIES
MALARIA
MALARIA PROPHYLAXIS
MALNOURISHED CHILDREN
MARITAL STATUS
MATERNAL AND CHILD HEALTH
MATERNAL CARE
MATERNAL HEALTH
MATERNAL HEALTH SERVICES
MATERNAL MORTALITY
MEDICAL CARE
MEDICAL DOCTORS
MEDICAL PERSONNEL
MEDICAL SUPPLIES
MINISTRY OF HEALTH
MISCARRIAGES
MORBIDITY
MORTALITY
MOSQUITO NETS
MOTHER
NATIONAL HEALTH
NAUSEA
NEWBORN
NUMBER OF CHILDREN
NURSES
NUTRITION
OBSTETRIC CARE
OFFICIAL DEVELOPMENT ASSISTANCE
PAP SMEAR
PATIENT
PATIENTS
PHARMACY
PHYSICAL EXAMINATIONS
PHYSICIAN
PHYSICIANS
POLICY IMPLICATIONS
POLICY RESEARCH
POLICY RESEARCH WORKING PAPER
POPULATION DENSITY
POSTNATAL CARE
PREGNANCIES
PREGNANCY
PREGNANT WOMEN
PRENATAL CARE
PRENATAL CARE UTILIZATION
PREVENTIVE HEALTH
PREVENTIVE HEALTH CARE
PRIMARY CARE
PRIMARY EDUCATION
PRIMARY HEALTH CARE
PRIMARY HEALTH CARE FACILITIES
PROBABILITY
PROGRESS
PROPHYLAXIS
PUBLIC HEALTH
QUALITY CARE
QUALITY OF CARE
QUALITY OF HEALTH
QUALITY OF SERVICES
RATES OF GROWTH
REDUCING MATERNAL MORTALITY
RISK PREGNANCIES
RURAL AREAS
SAFE MOTHERHOOD
SERVICE DELIVERY
SERVICE PROVISION
SEX
SKILLED ATTENDANCE
SKILLED ATTENDANCE AT DELIVERY
SKILLED ATTENDANTS
SOCIAL RESEARCH
SOCIOECONOMIC STATUS
STD
STIS
SYMPTOMS
SYPHILIS
TETANUS
TOBACCO
TREATMENT
TROPICAL MEDICINE
TUBERCULOSIS
VACCINATION
VACCINATION CAMPAIGN
VACCINE
VACCINES
VITAL SIGNS
VOMITING
WOMAN
WORKERS
YOUNG CHILDREN
Basinga, Paulin
Gertler, Paul J.
Soucat, Agnes L.B.
Binagwaho, Agnes
Soucat, Agnes L.B.
Sturdy, Jennifer R.
Vermeersch, Christel M.J.
Paying Primary Health Care Centers for Performance in Rwanda
geographic_facet Africa
Rwanda
relation Policy Research Working Paper;No. 5190
description Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
format Publications & Research :: Policy Research Working Paper
author Basinga, Paulin
Gertler, Paul J.
Soucat, Agnes L.B.
Binagwaho, Agnes
Soucat, Agnes L.B.
Sturdy, Jennifer R.
Vermeersch, Christel M.J.
author_facet Basinga, Paulin
Gertler, Paul J.
Soucat, Agnes L.B.
Binagwaho, Agnes
Soucat, Agnes L.B.
Sturdy, Jennifer R.
Vermeersch, Christel M.J.
author_sort Basinga, Paulin
title Paying Primary Health Care Centers for Performance in Rwanda
title_short Paying Primary Health Care Centers for Performance in Rwanda
title_full Paying Primary Health Care Centers for Performance in Rwanda
title_fullStr Paying Primary Health Care Centers for Performance in Rwanda
title_full_unstemmed Paying Primary Health Care Centers for Performance in Rwanda
title_sort paying primary health care centers for performance in rwanda
publisher World Bank, Washington, DC
publishDate 2014
url http://documents.worldbank.org/curated/en/2010/01/11696987/paying-primary-health-care-centers-performance-rwanda
http://hdl.handle.net/10986/19900
_version_ 1764444019068239872
spelling okr-10986-199002021-04-23T14:03:52Z Paying Primary Health Care Centers for Performance in Rwanda Basinga, Paulin Gertler, Paul J. Soucat, Agnes L.B. Binagwaho, Agnes Soucat, Agnes L.B. Sturdy, Jennifer R. Vermeersch, Christel M.J. ALCOHOL ALCOHOL USE ANEMIA ANTENATAL CARE BLEEDING BODY WEIGHT CHILD GROWTH MONITORING CHILD HEALTH CHILD HEALTH CARE CHILD HEALTH SERVICES CHILD SURVIVAL CHILDBIRTH CLEANLINESS CLINICAL PRACTICE CLINICS COMMUNITY HEALTH COMMUNITY HEALTH WORKERS CONTRACEPTIVE USE CONTRACEPTIVE USERS DEVELOPING COUNTRIES DIABETES DISTRICT HOSPITAL DRUGS EMPOWERING WOMEN EXPENDITURES FAMILIES FAMILY MEMBERS FAMILY PLANNING FINANCIAL MANAGEMENT GENOCIDE GLOBAL DEVELOPMENT GLOBAL HEALTH GOITER GONORRHEA GRID HEALTH BEHAVIOR HEALTH CARE CENTERS HEALTH CARE SERVICES HEALTH CENTERS HEALTH CENTRES HEALTH FACILITIES HEALTH FACILITY HEALTH FINANCING HEALTH INSURANCE HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH POLICY HEALTH PROBLEMS HEALTH SERVICES HEALTH SYSTEM HEALTH WORKERS HEART DISEASE HIGH BLOOD PRESSURE HIV HOSPITAL HOSPITALS HUMAN DEVELOPMENT IMMUNIZATION INCOME INFANT INFANT MORTALITY INFANTS INFORMED CONSENT INTERVENTION LAB TESTS LABORATORY SERVICES LAND OWNERSHIP LOW BIRTH WEIGHT LOW-INCOME COUNTRIES MALARIA MALARIA PROPHYLAXIS MALNOURISHED CHILDREN MARITAL STATUS MATERNAL AND CHILD HEALTH MATERNAL CARE MATERNAL HEALTH MATERNAL HEALTH SERVICES MATERNAL MORTALITY MEDICAL CARE MEDICAL DOCTORS MEDICAL PERSONNEL MEDICAL SUPPLIES MINISTRY OF HEALTH MISCARRIAGES MORBIDITY MORTALITY MOSQUITO NETS MOTHER NATIONAL HEALTH NAUSEA NEWBORN NUMBER OF CHILDREN NURSES NUTRITION OBSTETRIC CARE OFFICIAL DEVELOPMENT ASSISTANCE PAP SMEAR PATIENT PATIENTS PHARMACY PHYSICAL EXAMINATIONS PHYSICIAN PHYSICIANS POLICY IMPLICATIONS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POPULATION DENSITY POSTNATAL CARE PREGNANCIES PREGNANCY PREGNANT WOMEN PRENATAL CARE PRENATAL CARE UTILIZATION PREVENTIVE HEALTH PREVENTIVE HEALTH CARE PRIMARY CARE PRIMARY EDUCATION PRIMARY HEALTH CARE PRIMARY HEALTH CARE FACILITIES PROBABILITY PROGRESS PROPHYLAXIS PUBLIC HEALTH QUALITY CARE QUALITY OF CARE QUALITY OF HEALTH QUALITY OF SERVICES RATES OF GROWTH REDUCING MATERNAL MORTALITY RISK PREGNANCIES RURAL AREAS SAFE MOTHERHOOD SERVICE DELIVERY SERVICE PROVISION SEX SKILLED ATTENDANCE SKILLED ATTENDANCE AT DELIVERY SKILLED ATTENDANTS SOCIAL RESEARCH SOCIOECONOMIC STATUS STD STIS SYMPTOMS SYPHILIS TETANUS TOBACCO TREATMENT TROPICAL MEDICINE TUBERCULOSIS VACCINATION VACCINATION CAMPAIGN VACCINE VACCINES VITAL SIGNS VOMITING WOMAN WORKERS YOUNG CHILDREN Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes. 2014-09-02T14:19:26Z 2014-09-02T14:19:26Z 2010-01 http://documents.worldbank.org/curated/en/2010/01/11696987/paying-primary-health-care-centers-performance-rwanda http://hdl.handle.net/10986/19900 English en_US Policy Research Working Paper;No. 5190 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research Africa Rwanda