Improving Effective Coverage in Health : Do Financial Incentives Work?

In many low- and middle-income countries, health coverage has improved dramatically in the last two decades, but health outcomes have not. As such, effective coverage -- a measure of service delivery that meets a minimum standard of quality -- remains unacceptably low. This Policy Research Report ex...

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Main Authors:	de Walque, Damien, Kandpal, Eeshani, Wagstaff, Adam, Friedman, Jed, Neelsen, Sven, Piatti-Fünfkirchen, Moritz, Sautmann, Anja, Shapira, Gil, Van de Poel, Ellen
Format:	Book
Published:	Washington, DC: World Bank 2022
Subjects:	MEDICINE MEDICAL INSURANCE EFFECTIVE COVERAGE LOW INCOME COUNTRIES HEALTH INSURANCE
Online Access:	https://documents.worldbank.org/en/publication/documents-reports/documentdetail/099443305192239570/idu06b3b09eb0114104cd40949d0fbbf1bc40285 http://hdl.handle.net/10986/37326

id	okr-10986-37326
recordtype	oai_dc
spelling	okr-10986-373262022-07-06T20:07:05Z Improving Effective Coverage in Health : Do Financial Incentives Work? de Walque, Damien Kandpal, Eeshani Wagstaff, Adam Friedman, Jed Neelsen, Sven Piatti-Fünfkirchen, Moritz Sautmann, Anja Shapira, Gil Van de Poel, Ellen MEDICINE MEDICAL INSURANCE EFFECTIVE COVERAGE LOW INCOME COUNTRIES HEALTH INSURANCE In many low- and middle-income countries, health coverage has improved dramatically in the last two decades, but health outcomes have not. As such, effective coverage -- a measure of service delivery that meets a minimum standard of quality -- remains unacceptably low. This Policy Research Report examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF) or financial incentives to health workers on the front lines. The report draws on a rich set of rigorous studies and new analysis. When compared to business-as-usual, in low-income settings with centralized health systems PBF can result in substantial gains in effective coverage. However, the relative benefits of PBF are less clear when it is compared to two alternative approaches, decentralized facility financing which provides operating budget to frontline health services with facility autonomy on allocation, and demand-side financial support for health services (i.e., conditional cash transfers and vouchers). While PBF often results in improvements on the margins, closing the substantial gaps in effective health coverage is not yet within reach for many countries. Nonetheless, there are important lessons learned and experiences from the roll-out of PBF over the last decade which can guide health policies into the future. 2022-04-21T19:04:40Z 2022-04-21T19:04:40Z 2022-05-11 Book https://documents.worldbank.org/en/publication/documents-reports/documentdetail/099443305192239570/idu06b3b09eb0114104cd40949d0fbbf1bc40285 978-1-4648-1825-7 http://hdl.handle.net/10986/37326 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank Washington, DC: World Bank Publications & Research Publications & Research :: Publication World
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	MEDICINE MEDICAL INSURANCE EFFECTIVE COVERAGE LOW INCOME COUNTRIES HEALTH INSURANCE
spellingShingle	MEDICINE MEDICAL INSURANCE EFFECTIVE COVERAGE LOW INCOME COUNTRIES HEALTH INSURANCE de Walque, Damien Kandpal, Eeshani Wagstaff, Adam Friedman, Jed Neelsen, Sven Piatti-Fünfkirchen, Moritz Sautmann, Anja Shapira, Gil Van de Poel, Ellen Improving Effective Coverage in Health : Do Financial Incentives Work?
geographic_facet	World
description	In many low- and middle-income countries, health coverage has improved dramatically in the last two decades, but health outcomes have not. As such, effective coverage -- a measure of service delivery that meets a minimum standard of quality -- remains unacceptably low. This Policy Research Report examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF) or financial incentives to health workers on the front lines. The report draws on a rich set of rigorous studies and new analysis. When compared to business-as-usual, in low-income settings with centralized health systems PBF can result in substantial gains in effective coverage. However, the relative benefits of PBF are less clear when it is compared to two alternative approaches, decentralized facility financing which provides operating budget to frontline health services with facility autonomy on allocation, and demand-side financial support for health services (i.e., conditional cash transfers and vouchers). While PBF often results in improvements on the margins, closing the substantial gaps in effective health coverage is not yet within reach for many countries. Nonetheless, there are important lessons learned and experiences from the roll-out of PBF over the last decade which can guide health policies into the future.
format	Book
author	de Walque, Damien Kandpal, Eeshani Wagstaff, Adam Friedman, Jed Neelsen, Sven Piatti-Fünfkirchen, Moritz Sautmann, Anja Shapira, Gil Van de Poel, Ellen
author_facet	de Walque, Damien Kandpal, Eeshani Wagstaff, Adam Friedman, Jed Neelsen, Sven Piatti-Fünfkirchen, Moritz Sautmann, Anja Shapira, Gil Van de Poel, Ellen
author_sort	de Walque, Damien
title	Improving Effective Coverage in Health : Do Financial Incentives Work?
title_short	Improving Effective Coverage in Health : Do Financial Incentives Work?
title_full	Improving Effective Coverage in Health : Do Financial Incentives Work?
title_fullStr	Improving Effective Coverage in Health : Do Financial Incentives Work?
title_full_unstemmed	Improving Effective Coverage in Health : Do Financial Incentives Work?
title_sort	improving effective coverage in health : do financial incentives work?
publisher	Washington, DC: World Bank
publishDate	2022
url	https://documents.worldbank.org/en/publication/documents-reports/documentdetail/099443305192239570/idu06b3b09eb0114104cd40949d0fbbf1bc40285 http://hdl.handle.net/10986/37326
_version_	1764486958369734656

Improving Effective Coverage in Health : Do Financial Incentives Work?

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