Pay for performance (P4P) is an innovative approach that explicitly links financial investment in health to health results. While the P4P concept seems relatively straightforward, the mechanics of its implementation need to be planned very carefully to elicit the desired behavior change in a given country. To facilitate this planning, USAID through its Health Systems 20/20 project has developed the P4P Blueprint Guide. Intended for country health program managers, including those representing government, non-government, and donor agencies, this Guide offers the reader a systematic framework to document and structure his/her thought process, rationale, and ultimate decisions made when designing a P4P initiative. In following each recommended step of the Guide (facilitated by technical support from experienced P4P implementers), the user is alerted to factors and issues that can influence the success of a P4P scheme.
Upon completion of the Guide, the user will have produced a “blueprint” design or “gameplan” for introducing P4P to his/her program area/country. The suggested approach outlined in this Guide is based upon a successful tool used in Africa’s first regional Pay for Performance workshop sponsored by USAID. Some of the participating countries that developed blueprints have gone on to implement their P4P designs - turning their ideas into reality. In addition, the Guide draws upon the lessons learned from P4P implementation in developing countries.