This study examined the process of implementing the SSDI-PBI program in Malawi, including important factors that have influenced program implementation, acceptance, and adoption. The study also measured any changes in quantity and quality of services provided, as well as changes in provider motivation and behavior. Finally, it analyzed the costs of the program compared to its attributable benefits.
In 2012, Senegal's Ministry of Health and Social Affairs began piloting a results based financing (RBF) program focused on maternal and child health. Results for Development (R4D), supported by TRAction, conducted two studies aimed to: (1) enhance the primary care quality of care assessment instrument (QCAI) checklist; (2) design a secondary care QCAI with a focus on essential obstetric and neonatal care indicators; and (3) understand provider behavior and response to incentives under RBF programs. Studies were conducted as the MOH sought to integrate strategies to incentivize quality within its existing program, with particular attention to essential obstetric and neonatal care services.
This study examined how and to what extent countries are incentivizing quality of care within performance-based incentives (PBI) programs. This analysis provided program planners with a global comparison of the various approaches to defining, measuring, and incentivizing quality. Stemming from this landscape analysis, quality and quantity indicators were analyzed from 32 results-based financing (RBF) programs. The study team also produced five country case studies that illustrate the range of approaches to improving quality through PBI programs, and the successes and challenges of each.
Results-based financing (RBF) schemes have developed rapidly across sub-Saharan Africa, but a substantial knowledge gap about how RBF interventions impact quality of care of essential obstetric and newborn care (EONC) remains. Researchers from the University of Heidelberg and their partners at the College of Medicine Malawi aimed to reduce the knowledge gap by providing a scientific assessment of the expected and unexpected impacts of implementation of an RBF program in Malawi on EONC care quality. This study was co-funded by TRAction and the Norwegian Agency for Development Cooperation.
The Management for Results Strategy in Guatemala aims to efficiently allocate and manage human, financial, and technological resources toward the achievement of human development goals. This includes the articulation of policies, strategies, resources and processes to improve decision-making, transparency, accountability, and interactions between the Ministry of Public Health and Social Welfare (MSPAS) and the Ministry of Finance. Through the implementation of the Management for Results Strategy, Guatemala aims to honor three major pacts defined by the current Government: the Zero Hunger Pact; the Peace, Security and Justice Pact; and the Fiscal Reform and Competitiveness Pact. In particular, this is an opportunity for the MSPAS to improve the health service provision, in alignment with the Zero Hunger Pact, which aims to reduce maternal mortality and chronic malnutrition among children under five.