Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon
Performance-based financing is a complex health system intervention aimed at improving coverage and quality of care. This paper presents the results of an impact evaluation in Cameroon that seeks to isolate the role of specific components of the pe...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2017
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| Online Access: | http://documents.worldbank.org/curated/en/834601502391015068/Looking-into-the-performance-based-financing-black-box-evidence-from-an-impact-evaluation-in-the-health-sector-in-Cameroon http://hdl.handle.net/10986/27969 |
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okr-10986-279692022-08-01T00:24:56Z Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon de Walque, Damien Robyn, Paul Jacob Saidou, Hamadou Sorgho, Gaston Steenland, Maria PERFORMANCE-BASED FINANCING HEALTHCARE HEALTH SYSTEM MONITORING AND EVALUATION IMPACT EVALUATION Performance-based financing is a complex health system intervention aimed at improving coverage and quality of care. This paper presents the results of an impact evaluation in Cameroon that seeks to isolate the role of specific components of the performance-based financing approach on outcomes of interest, such as explicit financial incentives linked to results, additional resources available at the point of service delivery (not linked to performance), and enhanced supervision, coaching, and monitoring. Four evaluation groups were established to measure the effects of each component that was studied. In general, the results indicate that performance-based financing in Cameroon is an efficient mechanism to channel payments and funding to the provider level, leading to significant increases in utilization in the performance-based financing arm for several services (child and maternal vaccinations and use of modern family planning), but not for others, such as antenatal care visits and facility-based deliveries. However, for many of those outcomes, the differences between the performance-based financing group and the additional financing group are not significant. In terms of quality, performance-based financing was found to have a significant impact on the availability of essential inputs and equipment, qualified health workers, reduction in formal and informal user fees, and increased satisfaction among patients and providers. However, there was a clear effect of additional financing, irrespective of whether it was linked to incentives, in combination with reinforced supervision through performance-based financing. This result suggests that enhanced supervision and monitoring on their own are not sufficient to improve maternal and child health outcomes. 2017-08-24T21:15:03Z 2017-08-24T21:15:03Z 2017-08 Working Paper http://documents.worldbank.org/curated/en/834601502391015068/Looking-into-the-performance-based-financing-black-box-evidence-from-an-impact-evaluation-in-the-health-sector-in-Cameroon http://hdl.handle.net/10986/27969 English en_US Policy Research Working Paper;No. 8162 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Policy Research Working Paper Africa Cameroon |
| 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 |
PERFORMANCE-BASED FINANCING HEALTHCARE HEALTH SYSTEM MONITORING AND EVALUATION IMPACT EVALUATION |
| spellingShingle |
PERFORMANCE-BASED FINANCING HEALTHCARE HEALTH SYSTEM MONITORING AND EVALUATION IMPACT EVALUATION de Walque, Damien Robyn, Paul Jacob Saidou, Hamadou Sorgho, Gaston Steenland, Maria Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon |
| geographic_facet |
Africa Cameroon |
| relation |
Policy Research Working Paper;No. 8162 |
| description |
Performance-based financing is a complex
health system intervention aimed at improving coverage and
quality of care. This paper presents the results of an
impact evaluation in Cameroon that seeks to isolate the role
of specific components of the performance-based financing
approach on outcomes of interest, such as explicit financial
incentives linked to results, additional resources available
at the point of service delivery (not linked to
performance), and enhanced supervision, coaching, and
monitoring. Four evaluation groups were established to
measure the effects of each component that was studied. In
general, the results indicate that performance-based
financing in Cameroon is an efficient mechanism to channel
payments and funding to the provider level, leading to
significant increases in utilization in the
performance-based financing arm for several services (child
and maternal vaccinations and use of modern family
planning), but not for others, such as antenatal care visits
and facility-based deliveries. However, for many of those
outcomes, the differences between the performance-based
financing group and the additional financing group are not
significant. In terms of quality, performance-based
financing was found to have a significant impact on the
availability of essential inputs and equipment, qualified
health workers, reduction in formal and informal user fees,
and increased satisfaction among patients and providers.
However, there was a clear effect of additional financing,
irrespective of whether it was linked to incentives, in
combination with reinforced supervision through
performance-based financing. This result suggests that
enhanced supervision and monitoring on their own are not
sufficient to improve maternal and child health outcomes. |
| format |
Working Paper |
| author |
de Walque, Damien Robyn, Paul Jacob Saidou, Hamadou Sorgho, Gaston Steenland, Maria |
| author_facet |
de Walque, Damien Robyn, Paul Jacob Saidou, Hamadou Sorgho, Gaston Steenland, Maria |
| author_sort |
de Walque, Damien |
| title |
Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon |
| title_short |
Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon |
| title_full |
Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon |
| title_fullStr |
Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon |
| title_full_unstemmed |
Looking into the Performance-Based Financing Black Box : Evidence from an Impact Evaluation in the Health Sector in Cameroon |
| title_sort |
looking into the performance-based financing black box : evidence from an impact evaluation in the health sector in cameroon |
| publisher |
World Bank, Washington, DC |
| publishDate |
2017 |
| url |
http://documents.worldbank.org/curated/en/834601502391015068/Looking-into-the-performance-based-financing-black-box-evidence-from-an-impact-evaluation-in-the-health-sector-in-Cameroon http://hdl.handle.net/10986/27969 |
| _version_ |
1764466258277826560 |