As part of our mandate to gather and disseminate evidence and knowledge from global RBF experiences, RBF Health regularly organizes events, including seminars and capacity building workshops.
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Performance-Based Financing for Maternal and Child Health: Non-Experimental Evidence from Cambodia and Burundi




Ellen Van de Poel presents the findings of two studies that evaluate the impact of Performance-Based Financing (PBF) in Burundi and Cambodia. Both studies exploit the geographic expansion of PBF to estimate its effect on the utilization of maternal and child health services using data from the Demographic Health Surveys.

The studies found PBF to raise institutional deliveries, but effects were larger among the non-poor. In Cambodia, a substantial part of this effect arose from switching the location of institutional births from private to public facilities. The impact of PBF on births in public facilities is much greater if accompanied by maternity vouchers that cover user fees.  No effect on the volume of antenatal care was found in either study, although in Burundi the quality of antenatal care did improve substantially. The effects of PBF pilots were typically larger than those of the nationwide scale-up.

Cambodia has over a decade of experience with various PBF programs. Heterogeneous effects across schemes differing in design suggest that maintaining management authority within a health district while giving explicit service targets to facilities is more effective in raising utilization than contracting management to an NGO while denying it full autonomy and leaving financial penalties vague.

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Meeting number: 732 549 675
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A light lunch will be served


Ellen Van de Poel, Associate Professor of Health Economics, Institute of Health Policy and Management, Erasmus University Rotterdam

Ellen Van de Poel is an associate professor of Health Economics at the Institute of Health Policy and Management of the Erasmus University Rotterdam, Netherlands. Her work focuses on the evaluation of various health financing reforms aimed at improving access to health care and financial protection in the developing world.


Adam Wagstaff, Research Manager, Development Research Group, World Bank

Adam Wagstaff is Research Manager of the Human Development and Public Services team in the Development Research Group. He holds a DPhil in economics from the University of York and, before joining the Bank, was a Professor of Economics at the University of Sussex. He was an associate editor of the Journal of Health Economics for 20 years and has published extensively on a variety of aspects of the field.


The Effects of Performance Incentives on the Utilization and Quality of Maternal and Child Care in Burundi
Impact of Performance-Based Financing in a Low-Resource Setting: A Decade of Experience in CambodiaImpact of Performance-Based Financing in a Low-Resource Setting: A Decade of Experience in Cambodia
Performance-based financing of maternal and child health: non-experimental evidence from Cambodia and Burundi