The RBF e-learning course has been modified to adapt to the evolving needs of practitioners wanting to know more about RBF. It is now a widely accessible self-paced e-learning course, rather an annual facilitated one.  Strengthen your knowledge: join the course on Results-Based Financing!

The article in the British Medical Journal of Global Health asserts that performance-based financing is a donor fad. The paper questions the mainstream view that PBF is an effective, efficient and equitable approach to improving the performance of health systems. The essay concludes with a series of exhortations to recipient countries, bilateral and multilateral donors, recipient countries and donors, and independent researchers.

This report reviewed the cost-effectiveness of key health systems strengthening intentions, which includes results-based financing (RBF), voucher schemes, health insurance, personnel training, community mobilization, etc., with a total of 24 articles included in the review. Specifically on RBF, this report identified three studies on cost-effectiveness of the RBF programs, and the results showed that RBF was among the cost-effective interventions in addressing maternal and child health services.

In these two videos, Mr. Jean Benoit Falisse, a lecturer from the University of Edinburgh, provides an overview of Community Results-Based Financing (cRBF) country cases, key discussion points and challenges faced by community actors.

Introduction to cRBF

This commentary argues that it is crucial to pay greater attention to the “forest”—that is, overall health system reforms and how provider payment arrangements interact with these to influence health outcomes, as opposed to looking almost solely and more narrowly at the “trees”—that is, the details and impact of a P4P mechanism divorced from the underlying health system. P4P is a category of strategic purchasing, the effectiveness of which depends critically on its connections with the wider environment of purchaser–provider relations.

Although it is increasingly acknowledged within the Performance-Based Financing (PBF) research community that PBF is more than just payments based on outputs verified for quality, this narrow definition of PBF is still very present in many studies and evaluations. This leads to missed opportunities, misunderstandings and an unhelpful debate. Therefore, we reinforce the claim that PBF should be viewed as a reform package focused on targeted services with many different aspects that go beyond the health worker level.

Despite the increasing popularity of Results-Based Financing, there is little evidence or documentation of different verification strategies and how strategies relate to the verification results. Documentation of implementation processes including those pertaining to verification of outputs/results is lacking in World Bank-financed RBF projects in the health sector.


To describe how quality of care is incorporated into performance-based financing (PBF) programs, what quality indicators are being used, and how these indicators are measured and verified.

Results-Based Financing (RBF) schemes in healthcare are premised on the notion that “paying for results” rather than for inputs is more likely to improve performance. But getting from that attractive hypothesis to program efforts that improve quality of care and outcomes at population scale—in the real world—is far from simple.

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