Universal Health Coverage is one of the Sustainable Development Goal targets. But coverage without quality health services limits benefits to populations. Performance-based financing programs (PBF) use strategic purchasing of services to expand coverage and promote quality by measuring quality and rewarding good performance. The widespread presence of PBF programs in lower and middle-income countries provide an opportunity to introduce and test new approaches for measuring and improving quality at scale.

This video explains the importance of evidence in RBF, highlighting its value for improved design and implementation, and learning.

This external review of the Health Results Innovation Trust Fund was completed by IOD Parc in 2018. The mid-term review assessed the performance and progress of the HRITF portfolio and makes recommendations for on-going and future RBF programming. A management letter was issued in response to the review.

The early phases of the HRITF Learning Strategy were concerned with initiating evaluations (including producing tools that would aid in developing evaluations) and learning from the early experiences of implementing RBF programs across its vast portfolio. To support that effort, the HRITF has developed multiple toolkits which have been used by thousands. A rich array of learning has been generated from implementation, particularly through in-country studies and cross-country analyses and topical learning.

With growing interest in the diffusion of policy innovations across countries, this study explores how the features of performance-based financing “diffusion entrepreneurs” and their actions affect the outcomes of diffusion processes.

Our Impact Evaluation Toolkit helps practitioners design and implement impact evaluations, with a focus on Results-Based Financing in maternal and child health programs. The Toolkit consists of 1) guidelines for best practices and 2) tools to implement guideline recommendations such as:

  • terms of reference for team members/survey firms
  • maternal and child health indicators of interest
  • research protocols
  • questionnaires
  • training manuals and curricula
  • fieldwork supervision materials

Performance-based financing (PBF) schemes have been expanding rapidly across low and middle income countries in the past decade, with considerable external financing from multilateral, bilateral and global health initiatives. Many of these countries have been fragile and conflict-affected (FCAS), but while the influence of context is acknowledged to be important to the operation of PBF, there has been little examination of how it affects adoption and implementation of PBF.

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