This World Bank and Government of China paper examines health provider payment reforms in China—the present system and how it evolved, and changes that would improve it in the context of ongoing health reform. It includes sections on experiments with case-based payment systems, pay-for-performance, alternative government budget payment methods, and an examination of the lessons learned and next steps in China.
Available in English and Chinese.
This paper finds that where utilization of nutrition interventions is low, there is significant potential for CCTs to play a greater role in reducing undernutrition by encouraging groups at high risk of undernutrition to utilize effective nutrition services and by encouraging improved quality of these services. Several key design modifications—e.g. limiting CCT eligibility to the “window of opportunity” for nutrition impact, prioritizing nutrition-related conditionalities based on best practices in nutrition, increasing attention to supply-side investments for nutrition and health services, and improving coordination with other agencies and stakeholders — could allow CCTs to better contribute to eliminating child undernutrition in the developing world. At the same time, there is much to be learned about the effectiveness and cost-effectiveness of various design options, as well as their appropriateness in different country contexts.
An article from Health Policy and Planning, Volume 26, Issue 1:
It is now more than 2 years since the Ministry of Health and Family Welfare of the Government of Bangladesh implemented the Maternal Health Voucher Scheme, a specialized form of demand-side financing programme. To analyse the early lessons from the scheme, information was obtained through semi-structured interviews with stakeholders at the sub-district level. The analysis identified a number of factors affecting the efficiency and performance of the scheme in the program area: delay in the release of voucher funds, selection criteria used for enrolling pregnant women in the programme, incentives created by the reimbursement system, etc.
Author/s: Mona Sharan, Saifuddin Ahmed, Joseph Naimoli, Mismay Ghebrehiwet, and Khama Rogo
An issue of common concern to both demand- and supply-side RBF programs: the readiness of the health system to respond to an anticipated increase in demand for care. This paper describes findings from Eritrea for an RBF program to increase the use and improve the quality of obstetric services and highlights challenges for future RBF programs that aim to improve maternal health services.
In Results-Based Financing (RBF) schemes, verification is an essential element of program implementation and to date different schemes have adopted different approaches to verification. To better understand verification, we undertook a rapid review of selected recent experiences and provide snapshots of four countries and several global health partnerships. These snapshots address why verification had been introduced and some minimal description of how the process was carried out, where, by whom, using what methods, and, with what effect. This provides a preliminary collection of experiences with verification, in a diverse range of settings, under different financing mechanisms.
Author/s: Paulin Basinga, Paul Gertler, Agnes Binagwaho, Agnes Soucat, Jennifer Sturdy, Christel Vermeersch
This Policy Research Working Paper published by the World Bank reports on a study that examines the impact of Pay for Performance (P4P) on maternal and child health services in Rwanda. It uses data produced from a prospective quasiexperimental evaluation design nested into the P4P program rollout. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care.
If programs are undertaken without conscious attention to including disadvantaged groups, there are a priori reasons for suspecting that they will favor the better-off, thereby exacerbating inequalities. But such an outcome is far from inevitable.
This paper presents the findings of a review of 260 Health, Nutrition, and Population (HNP) projects with a health sector performance theme in order to understand the nature and extent of World Bank experience with RBF for Health.