To strengthen Haiti’s primary health care (PHC) system, the country first piloted performance-based financing (PBF) in 1999 and subsequently expanded the approach to most internationally funded non-government organizations. PBF complements support (training and technical assistance).

This study evaluates (a) the separate impact of PBF and international support on PHC’s service delivery; (b) the combined impact of PBF and technical assistance on PHC’s service delivery; and (c) the costs of PBF implementation in Haiti.

Building awareness for results-based financing (RBF) and on studies about its contextual feasibility and appropriateness is an important activity that can help policymakers to make informed decisions about the use of RBF and its possible design. Another critical— and related— activity is holding stakeholder consultations. These consultations can help to ensure that the design of the RBF program is tailored to local realities. 

As of March 2011, 27 NGOs and 16 public sites within six departmental directorates are supported under a performance-based approach.  The schematic walks through the different steps taken in the Haiti PBC model in relation to contracting, verification and payment while highlighting the different actors involved in the process.

This presentation tells you everything you need to know about P4P, specifically related to paying health care providers. Examples from the USA, UK, Brazil and Haiti are included, as well as:

  • Performance Incentives to Households and/or Providers
  • Paying Providers Based on Performance
  • Types of Measures
  • Different Methods to Pay Based on Performance
  • What is Financial Risk for providers under P4P?


From a World Bank-World Health Organization Strategic Purchasing Workshop in Bangkok in December 2009.

This presentation was given by Dr. Rena Eichler of Broad Branch Associates at a National Workshop on RBF in India during January 2010.

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