Can paying for results help to achieve the Millennium Development Goals? A critical review of selected evaluations of results‐based financing

Abstract

When RBF schemes are used, they should be designed carefully, including the level at which they are targeted, the choice of targets and indicators, the type and magnitude of incentives, the proportion of financing that is paid based on results, and the ancillary components of the scheme. For RBF to be effective, it must be part of an appropriate package of interventions, and technical capacity or support must be available. RBF schemes should be monitored for possible unintended effects and evaluated using rigorous study designs.

Motivating health workers up to a limit: partial effects of performance-based financing on working environments in Nigeria

“…Non-financial incentives have been found to be significant in motivating health workers in Nigeria (Bhatnagar 2014). It also supports the notion that design of PBF is crucial and depends on a number of complementary factors (Oxman and Fretheim 2009). A key distinction in responses between health workers in PBF and non-PBF facilities, despite the latter reportedly receiving regular supervision was the fact that supervision in PBF facilities resulted in performance feedback tied to incentives.…”

“…Programme designers and managers need to monitor distribution of individual bonus payments closely in order to prevent health workers from losing interest or 'gaming'. In addition, the size of the incentive required to bring about the desired change in behaviour needs to be studied in greater detail (Oxman and Fretheim 2009).…”

“…By changing from input to output-based financing, PBF rests on the assumption that it will motivate health workers to 'change behaviour significantly and achieve results' and 'translate their knowledge into better practice' Oxman and Fretheim 2009). However, the effects of PBF on health worker motivation in LMIC have not been systematically evaluated and results remain mixed at best (Witter 2013).…”

Designing a Framework for “Iranian Pay for Performance” Program for Non-Medical Workforce in Hospitals

“…This has been reflected in postponement of employees' payments in other countries (37), which could influence all of the program's effects. The Iran's program was implemented simultaneously for all public hospitals.…”

“…U n c o r r e c t e d P r o o f issues (37). Moreover, the prevention of such administrative barriers will be necessary through continuous evaluation and timely feedback to hospitals.…”