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http://ssrn.com/abstract=1543049
 
 

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Paying Primary Health Care Centers for Performance in Rwanda


Paulin Basinga


affiliation not provided to SSRN

Paul J. Gertler


University of California, Berkeley - Haas School of Business; National Bureau of Economic Research (NBER)

Agnes Binagwaho


Ministry of Health of Rwanda - Harvard Medical School - Darmouth College, Geisel School of Medicine

Agnes L.B. Soucat


affiliation not provided to SSRN

Jennifer R. Sturdy


affiliation not provided to SSRN

Christel Vermeersch


World Bank - Young Professionals Program

January 1, 2010

World Bank Policy Research Working Paper No. 5190

Abstract:     
Paying 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.

Number of Pages in PDF File: 29

Keywords: Health Monitoring & Evaluation, Population Policies, Health Systems Development & Reform, Disease Control & Prevention, Adolescent Health

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Date posted: January 27, 2010  

Suggested Citation

Basinga, Paulin and Gertler, Paul J. and Binagwaho, Agnes and Soucat, Agnes L.B. and Sturdy, Jennifer R. and Vermeersch, Christel, Paying Primary Health Care Centers for Performance in Rwanda (January 1, 2010). World Bank Policy Research Working Paper Series, Vol. , pp. -, 2010. Available at SSRN: http://ssrn.com/abstract=1543049

Contact Information

Paulin Basinga (Contact Author)
affiliation not provided to SSRN
No Address Available
Paul J. Gertler
University of California, Berkeley - Haas School of Business ( email )
545 Student Services Building
Berkeley, CA 94720
United States
510-642-1418 (Phone)
510-642-4700 (Fax)
National Bureau of Economic Research (NBER)
1050 Massachusetts Avenue
Cambridge, MA 02138
United States
Agnes Binagwaho
Ministry of Health of Rwanda - Harvard Medical School - Darmouth College, Geisel School of Medicine
Kigali
Rwanda
Agnes L.B. Soucat
affiliation not provided to SSRN
No Address Available
Jennifer R. Sturdy
affiliation not provided to SSRN
No Address Available
Christel Vermeersch
World Bank - Young Professionals Program ( email )
Washington, DC 20433
United States
Feedback to SSRN


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