Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs

Abstract

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Pagos por desempeño para mejorar estado nutricional infantil: impacto de los convenios de apoyo presupuestario en tres regiones peruanas con alta prevalencia de desnutrición cronica infantil, 2010-2014

“…Según Miller y Singer (14) , su aplicación a los sistemas de salud a los países de ingreso medio y bajo se ha extendido durante los últimos quince años. En América Latina, Argentina (12) y Nicaragua (15) han implementado esquemas para mejorar la calidad y acceso de servicios de salud materno infantil, y a nivel mundial, en Ruanda (13) , China (16) India (17) , entre otros.…”

“…Asimismo, diversas revisiones de evidencia advierten sobre el poco consenso sobre la efectivdad de diferentes esquemas de pagos por desempeño aplicados por Gobiernos para logros en salud (14,21,22) . Precisamente por ello, este estudio busca estimar el impacto promedio atribuible a la suscripción de los CAP sobre los indicadores que miden la cobertura de los servicios de salud priorizados y el estado nutricional de los niños menores de 5 años en las zonas en donde fue implementado entre 2010 y 2014.…”

Effect of conditional cash transfer schemes on registration of the birth of a female child in India

“…Pay-for-performance incentives to health care providers in Rwanda have been able to increase institutional delivery rates by 23% and preventive service use among children under the age of 4 years by 25-50%. 21 It also led to a 15% increase in the rate of HIV testing and counseling among couples, and an 18% increase in the probability that both partners in HIV discordant households had been tested for HIV at least once. 21 Payments, as conditional cash transfers, are made for using prevention services and achieving educational targets, and are believed to improve health outcomes.…”

“…21 It also led to a 15% increase in the rate of HIV testing and counseling among couples, and an 18% increase in the probability that both partners in HIV discordant households had been tested for HIV at least once. 21 Payments, as conditional cash transfers, are made for using prevention services and achieving educational targets, and are believed to improve health outcomes. 22 Financial incentives attached to the Majoni scheme were aimed at ensuring the birth registration of female children and thereby increase their chances of survival.…”

“…A 25% decrease in the prevalence of anemia among primary school children in China and an improvement of anthropometric indicators of malnutrition by 6% in children of urban slums in India due to performance incentives paid to school principals and day care workers respectively, are some of the examples of achieving the specified targets. 21 A common alternative to achieving pre-specified performance targets is to reward the use of health services and inputs, particularly those that are relatively sensitive to provider effort. Pay-for-performance incentives to health care providers in Rwanda have been able to increase institutional delivery rates by 23% and preventive service use among children under the age of 4 years by 25-50%.…”