In the April 2011 issue of the Lancet, researchers publish findings of the effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance.

An article about the launch of the Rwanda community health worker incentive program:
March 2010, Rwandan community health workers, health facility staff, district authorities and Ministry of Health (MOH) representatives gathered in Nyarubaka, a sector in Kamonyi district, for a ceremony inaugurating a new performance-based financing (PBF) program that, along with a new community health worker cooperative incentive program, aims to improve maternal and child health. The program provides incentives to eligible women conditional on meeting up to three targets:

This diagram shows the steps in the Rwanda health center PBF model on verification, payment request submission, funds transfer and the results of counter-verification while highlighting the actors involved.

Excitement is growing about results-based financing (RBF) for health, a financing mechanism that turns the traditional donor approach of paying for inputs on its head. RBF for health is a cash payment or non-monetary transfer made to a national or sub-national government, provider, payer, or consumer of health services after predefined results have been attained and verified. Payment is conditional on measureable actions being taken. Where RBF has been tried, experience suggests it can improve health outcomes and strengthen health systems.

This page contains presentations and documents from the Health Systems Innovations Workshop held January 25-29, 2010 in Abuja, Nigeria.

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.

This presentation was given by the Ministry of Health of Rwanda at an RBF workshop in Rwanda in October, 2008.

It contains the chronology and description of the country program such as: country context, partner coordination, institutional set up, challenges, and some results and lessons learned.

A presentation by Dr. Claude Sekabaraga, former Director for Policy, Planning, and Capacity Building in the Ministry of Health of Rwanda, now working for the World Bank's Africa Region. He presented this at an RBF workshop in Rwanda in October 2008.

This presentation provides the context for health care reforms in Rwanda, such as results-based interventions, autonomization, decentralization and human resources management and discusses Rwanda's progress towards meeting the Millennium Development Goals (MDGs).


A presentation by Agnes Soucat, which explores performance-based financing in Rwanda.

This resource explores performance-based financing in Rwanda, including 

  • What is Performance-Based Financing in Health in Rwanda?
  • Results on the Volume and Quality of Services
  • Impacts of Performance-Based Financing
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