Using Performance Incentives to Improve Health Outcomes

41 Pages Posted: 20 Apr 2016

See all articles by Paul J. Gertler

Paul J. Gertler

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

Christel Vermeersch

World Bank

Date Written: June 1, 2012


This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0-11 months and on the height-for-age of children 24-49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill.

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

Suggested Citation

Gertler, Paul J. and Vermeersch, Christel, Using Performance Incentives to Improve Health Outcomes (June 1, 2012). World Bank Policy Research Working Paper No. 6100, Available at SSRN:

Paul J. Gertler (Contact Author)

University of California, Berkeley - Haas School of Business ( email )

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National Bureau of Economic Research (NBER)

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Christel Vermeersch

World Bank ( email )

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