Ellen Van De Poel recently joined the Global Financing Facility Secretariat. In this TEDx talk, she makes the case for increased scrutiny of incentives in healthcare. Every day almost 17,000 women and children die worldwide. We need health systems which can get simple drugs and vaccines to those who need them.

This presentation explains how improvements in quality of care are measured and paid for in Results-Based Financing programs for health. The presentation includes the following sections:

  • Existing Instruments and Methods
  • Using Data for decision making
  • Verifying Data Accuracy
  • Innovations in Measuring and Paying for Quality
© Aisha Faquir/World Bank
A young boy points to the letter F, with his teacher's help in a classroom in rural Nepal. Photo: © Aisha Faquir/World Bank

The three sectors of Human Development came together in November 2016 to exchange experiences on Results Based Financing; identify the key lessons learned in each sector; and discuss to what extent those lessons apply cross-sectorally.

Day 1, Session 1 - Learning from HRITF portfolio

Although domestic HIV/AIDS financing is increasing, international HIV/AIDS financing has plateaued. Providing incentives for the health system (i.e. performance-based financing [PBF]) may help countries achieve more with available resources. We systematically reviewed effects of PBF on HIV/AIDS service delivery to inform WHO guidelines.

This video highlights the importance of quality when measuring success of Results-Based Financing programs.


This study examines the medium-term effects of a two-year cash transfer program targeted to adolescent girls and young women. Significant declines in HIV prevalence, teen pregnancy, and early marriage among recipients of unconditional cash transfers (UCTs) during the program evaporated quickly two years after the cessation of transfers. However, children born to UCT beneficiaries during the program had significantly higher height-for-age z-scores at follow-up.

This report serves as a discussion paper, and does not mean to be a thorough review of different health systems apporaches to quality of care. Instead, it aims to provide evidence of key approaches in order to foster discussion on quality improvement in low- and middle-income countries using health system level interventions that could supplement facility-based RBF interventions.

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