About RBF

Results-Based Financing (RBF) for Health is a national-level tool for increasing the quantity and quality of health services used or provided based on cash or in-kind payments to providers, payers, and consumers after predetermined health results (outputs or outcomes) have been achieved. It combines the use of incentives for health-related behaviors with a strong focus on results, and can support efforts to achieve the Millennium Development Goals (MDGs).
 
Combining incentives with results has generated excitement among policy-makers in many low- and middle-income countries. It has demonstrated potential to change behaviors and increase the availability of health services in countries as disparate as Argentina, Haiti, and Rwanda. Governments, the international development community, the private sector, and NGOs evince substantial and growing interest in RBF.
 
RBF is an innovative financing strategy that can increase the impact of investments in health by providing a financial or in-kind reward conditional upon achievement of agreed performance goals. RBF is an umbrella term that includes output-based aid, performance-based financing, provider payment incentives, vouchers, contracting linked to particular targets, and conditional cash payments and transfers to households.
 
In some countries, RBF may take the form of paying a bonus to health facilities that meet certain quantity or quality targets, such as percent of women delivering their babies in a facility. Other countries are designing RBF mechanisms to provide incentives and support to the poor to overcome hidden barriers to using services, such as the cost of transport.
 
RBF is used increasingly by national health programs as a tool to strengthen delivery systems and accelerate progress towards national health objectives, particularly those linked to MDGs 4 and 5. RBF can help focus government and donor attention on outputs and outcomes -- for example, percentage of women receiving antenatal care -- rather than inputs or processes (e.g. training, salaries, medicines). RBF mechanisms may reinforce efforts to improve the timeliness, credibility and accuracy of national reporting and monitoring; and may even help spur creative reforms that confer authority and flexibility to local, service-delivery levels, fostering problem-solving where it is most needed.