Paying Primary Health Care Centers for Performance in Rwanda

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dc.creatorBasinga, Paulin
dc.creatorGertler, Paul J.
dc.creatorSoucat, Agnes L.B.
dc.creatorBinagwaho, Agnes
dc.creatorSoucat, Agnes L.B.
dc.creatorSturdy, Jennifer R.
dc.creatorVermeersch, Christel M.J.
dc.date2014-09-02T14:19:26Z
dc.date2014-09-02T14:19:26Z
dc.date2010-01
dc.date.accessioned2026-07-01T01:13:58Z
dc.descriptionPaying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2010/01/11696987/paying-primary-health-care-centers-performance-rwanda
dc.identifierhttps://hdl.handle.net/10986/19900
dc.identifierhttps://doi.org/10.1596/1813-9450-5190
dc.identifier.urihttp://hdl.handle.net/123456789/416327
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationPolicy Research Working Paper;No. 5190
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectALCOHOL
dc.subjectALCOHOL USE
dc.subjectANEMIA
dc.subjectANTENATAL CARE
dc.subjectBLEEDING
dc.subjectBODY WEIGHT
dc.subjectCHILD GROWTH MONITORING
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH CARE
dc.subjectCHILD HEALTH SERVICES
dc.subjectCHILD SURVIVAL
dc.subjectCHILDBIRTH
dc.subjectCLEANLINESS
dc.subjectCLINICAL PRACTICE
dc.subjectCLINICS
dc.subjectCOMMUNITY HEALTH
dc.subjectCOMMUNITY HEALTH WORKERS
dc.subjectCONTRACEPTIVE USE
dc.subjectCONTRACEPTIVE USERS
dc.subjectDEVELOPING COUNTRIES
dc.subjectDIABETES
dc.subjectDISTRICT HOSPITAL
dc.subjectDRUGS
dc.subjectEMPOWERING WOMEN
dc.subjectEXPENDITURES
dc.subjectFAMILIES
dc.subjectFAMILY MEMBERS
dc.subjectFAMILY PLANNING
dc.subjectFINANCIAL MANAGEMENT
dc.subjectGENOCIDE
dc.subjectGLOBAL DEVELOPMENT
dc.subjectGLOBAL HEALTH
dc.subjectGOITER
dc.subjectGONORRHEA
dc.subjectGRID
dc.subjectHEALTH BEHAVIOR
dc.subjectHEALTH CARE CENTERS
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH CENTERS
dc.subjectHEALTH CENTRES
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH FACILITY
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROBLEMS
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH WORKERS
dc.subjectHEART DISEASE
dc.subjectHIGH BLOOD PRESSURE
dc.subjectHIV
dc.subjectHOSPITAL
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINFANT
dc.subjectINFANT MORTALITY
dc.subjectINFANTS
dc.subjectINFORMED CONSENT
dc.subjectINTERVENTION
dc.subjectLAB TESTS
dc.subjectLABORATORY SERVICES
dc.subjectLAND OWNERSHIP
dc.subjectLOW BIRTH WEIGHT
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMALARIA
dc.subjectMALARIA PROPHYLAXIS
dc.subjectMALNOURISHED CHILDREN
dc.subjectMARITAL STATUS
dc.subjectMATERNAL AND CHILD HEALTH
dc.subjectMATERNAL CARE
dc.subjectMATERNAL HEALTH
dc.subjectMATERNAL HEALTH SERVICES
dc.subjectMATERNAL MORTALITY
dc.subjectMEDICAL CARE
dc.subjectMEDICAL DOCTORS
dc.subjectMEDICAL PERSONNEL
dc.subjectMEDICAL SUPPLIES
dc.subjectMINISTRY OF HEALTH
dc.subjectMISCARRIAGES
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectMOSQUITO NETS
dc.subjectMOTHER
dc.subjectNATIONAL HEALTH
dc.subjectNAUSEA
dc.subjectNEWBORN
dc.subjectNUMBER OF CHILDREN
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectOBSTETRIC CARE
dc.subjectOFFICIAL DEVELOPMENT ASSISTANCE
dc.subjectPAP SMEAR
dc.subjectPATIENT
dc.subjectPATIENTS
dc.subjectPHARMACY
dc.subjectPHYSICAL EXAMINATIONS
dc.subjectPHYSICIAN
dc.subjectPHYSICIANS
dc.subjectPOLICY IMPLICATIONS
dc.subjectPOLICY RESEARCH
dc.subjectPOLICY RESEARCH WORKING PAPER
dc.subjectPOPULATION DENSITY
dc.subjectPOSTNATAL CARE
dc.subjectPREGNANCIES
dc.subjectPREGNANCY
dc.subjectPREGNANT WOMEN
dc.subjectPRENATAL CARE
dc.subjectPRENATAL CARE UTILIZATION
dc.subjectPREVENTIVE HEALTH
dc.subjectPREVENTIVE HEALTH CARE
dc.subjectPRIMARY CARE
dc.subjectPRIMARY EDUCATION
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE FACILITIES
dc.subjectPROBABILITY
dc.subjectPROGRESS
dc.subjectPROPHYLAXIS
dc.subjectPUBLIC HEALTH
dc.subjectQUALITY CARE
dc.subjectQUALITY OF CARE
dc.subjectQUALITY OF HEALTH
dc.subjectQUALITY OF SERVICES
dc.subjectRATES OF GROWTH
dc.subjectREDUCING MATERNAL MORTALITY
dc.subjectRISK PREGNANCIES
dc.subjectRURAL AREAS
dc.subjectSAFE MOTHERHOOD
dc.subjectSERVICE DELIVERY
dc.subjectSERVICE PROVISION
dc.subjectSEX
dc.subjectSKILLED ATTENDANCE
dc.subjectSKILLED ATTENDANCE AT DELIVERY
dc.subjectSKILLED ATTENDANTS
dc.subjectSOCIAL RESEARCH
dc.subjectSOCIOECONOMIC STATUS
dc.subjectSTD
dc.subjectSTIS
dc.subjectSYMPTOMS
dc.subjectSYPHILIS
dc.subjectTETANUS
dc.subjectTOBACCO
dc.subjectTREATMENT
dc.subjectTROPICAL MEDICINE
dc.subjectTUBERCULOSIS
dc.subjectVACCINATION
dc.subjectVACCINATION CAMPAIGN
dc.subjectVACCINE
dc.subjectVACCINES
dc.subjectVITAL SIGNS
dc.subjectVOMITING
dc.subjectWOMAN
dc.subjectWORKERS
dc.subjectYOUNG CHILDREN
dc.titlePaying Primary Health Care Centers for Performance in Rwanda

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