Improving Effective Coverage in Health : : Do Financial Incentives Work?

• Superior document: Policy Research Reports
• Author: de Walque, Damien.
• TeilnehmendeR: Kandpal, Eeshani.; Wagstaff, Adam.; Friedman, Jed.; Piatti-Fünfkirchen, Moritz.; Sautmann, Anja.; Shapira, Gil.; Van de Poel, Ellen.
• Place / Publishing House: Washington, D. C. : : World Bank Publications,, 2022.; ©2022.
• Year of Publication: 2022
• Edition: 1st ed.
• Language: English
• Series: Policy Research Reports
• Physical Description: 1 online resource (291 pages)

Table of Contents

Front Cover -- Contents -- Foreword -- Acknowledgments -- About the Authors -- Overview -- Abbreviations -- Chapter 1 Introduction -- Introduction -- Conclusions -- References -- Chapter 2 Effective Coverage: A Framework Linking Coverage and Quality -- Introduction -- Coverage, quality, and effective coverage -- Empirical applications -- Expanding the work on effective coverage by using data collected in health facilities -- Conclusions -- Notes -- References -- Chapter 3 Quality of Care: A Framework for Measurement -- Introduction -- Theoretical framework for assessing quality of care -- Measuring quality of care for research and policy -- Conclusions -- Notes -- References -- Chapter 4 Decomposing the Constraints to Quality of Care Using Data on Antenatal Care Consultations from Five Sub-Saharan African Countries -- Introduction -- Why antenatal care? -- Data -- Results -- Conclusions -- Annex 4A: Additional tables and figures -- Annex 4B: Data -- References -- Chapter 5 Performance-Based Financing Improves Coverage of Reproductive, Maternal, and Child Health Interventions -- Introduction -- PBF, health system performance, and health worker effort in theory -- Evidence of the impact of PBF on the quality and quantity of health service delivery in LMICs -- Impact of PBF on health worker motivation and satisfaction in six countries -- Results -- PBF, quality of care, and idle capacity -- Conclusions -- Notes -- References -- Chapter 6 Policy Alternatives to Performance-Based Financing -- Introduction -- Systematic review and meta-analysis of demand- and supply-side financial incentives -- Comparing the PBF and DFF approaches -- PBF, DFF, and institutional deliveries -- PBF, DFF, and baseline effort -- Complementarities in the PBF and DFF approaches -- Discussion and conclusions -- Annex 6A: Additional tables -- Notes -- References.

Chapter 7 Performance-Based Financing as a Health System Reform and Cautionary Evidence on Performance Pay and Irrelevant Care -- Introduction -- Provision of nonindicated treatment in the context of financial incentives -- PBF as a health system reform -- Conclusion -- Notes -- References -- Chapter 8 Conclusion and Operational Implications -- Message 1: Recognize that sustainability is about more than just money -- Message 2: Support the four facility financing tenets -- Message 3: Understand PBF incentives in a broader health system context -- Message 4: Explore opportunities of maturing technologies -- Building a forward-looking research agenda -- References -- Boxes -- Box O.1 In Focus: Action items for task teams working on health financing reform -- Box 1.1 In Focus: A short history of performance-based financing and the related evaluation agenda -- Box 3.1 In Focus: Identifying misuse of care: A case study of malaria treatment in Mali -- Box 3.2 In Focus: Measuring quality of care and provider effort in antenatal and maternal care -- Box 4.1 In Focus: Exploring the drivers of variation in the content of care -- Box 4.2 In Focus: Does discrimination contribute to poor effort? -- Box 5.1 In Focus: A middle-income country's experience with performance-based financing: The case of Argentina and Plan Nacer and Programa Sumar -- Box 5.2 In Focus: Theoretical underpinnings of health worker motivation and paying for performance -- Box 5.3 In Focus: Measurement of worker motivation and satisfaction -- Box 5.4 In Focus: Heterogeneous effects of performance-based financing on motivation and satisfaction: An example from Nigeria -- Box 6.1 In Focus: Kyrgyz Republic PBF pilot -- Box 6.2 In Focus: Demand-side interventions and incentives for increasing preventive screening for noncommunicable diseases in Armenia.

Box 6.3 In Focus: Systematic review search results -- Box 6.4 In Focus: Mean effect size computation and subgroup analysis -- Box 6.5 In Focus: Effect size heterogeneity -- Box 6.6 In Focus: Combining supply- and demand-side incentives -- Box 6.7 In Focus: PBF and equity -- Box 6.8 In Focus: How do impacts depend on the baseline outcome values? Results from the meta-analysis -- Box 8.1 In Focus: Combining technological innovations to facilitate strategic purchasing -- Figures -- Figure O.1 Effective coverage contours for antenatal care -- Figure O.2 Lay of the land in centralized health systems in low-income countries -- Figure O.3 Availability of drugs and consumables, equipment, and other supplies for providing antenatal care -- Figure O.4 Know-can-do gaps in the provision of antenatal care -- Figure O.5 Provision of unnecessary care in antenatal care provision in five Sub-Saharan African countries -- Figure O.6 Impacts of performance-based financing on facility physical capacity in Cameroon and Nigeria -- Figure O.7 Impacts of performance-based financing on idle capacity-or the know-can-do gap-in Cameroon and Nigeria -- Figure O.8 Comparison of the pooled impact of performance-based and unconditional facility financing in five Sub-Saharan African countries (Cameroon, Nigeria, Rwanda, Zambia, and Zimbabwe) -- Figure O.9 Impacts of PBF, vouchers, and conditional cash transfers on the utilization of maternal and child health services: Results from a meta-analysis -- Figure 1.1 Lay of the land in centralized health systems -- Figure 1.2 Lay of the land in health systems with the addition of demand- and supply-side incentives -- Figure 2.1 Utilization, coverage, and effective coverage -- Figure 2.2 Coverage, quality, effective coverage, and the care cascade -- Figure 2.3 Effective coverage tree and its decomposition.

Figure 2.4 Effective coverage and its decomposition as the product of coverage and quality -- Figure 2.5 Effective coverage contours and isocurves -- Figure 2.6 Effective coverage and its decomposition: Antenatal care and pneumonia -- Figure 2.7 Effective coverage contours for antenatal care -- Figure 2.8 Effective coverage contours for hypertension treatment -- Figure 2.9 Effective coverage contours for tuberculosis treatment -- Figure 2.10 Effective coverage contours for HIV/AIDS treatment in Mozambique, by wealth quintile, 2015 -- Figure 2.11 Effective coverage contours for child malaria and diarrhea treatment -- Figure 2.12 Effective coverage contours for various medical conditions -- Figure 2.13 Potential data sources for measuring effective coverage -- Figure 3.1 Prescriptions for antimalarials in the malaria case study -- Figure 4.1 Effective antenatal care coverage in five Sub-Saharan African countries -- Figure 4.2 Availability of drugs and consumables, equipment, and other supplies for providing antenatal care -- Figure 4.3 Performance in patient-provider interactions during antenatal care -- Figure B4.1.1 Variation in content of care in patient-provider interactions in antenatal care -- Figure 4.4 Know-can-do gaps in the provision of antenatal care -- Figure 4.5 Overuse in antenatal care provision in five Sub-Saharan African countries -- Figure 4.6 Correlation between idle capacity and provider type -- Figure B4.2.1 Inequality in the provision of ANC and effective ANC in the Democratic Republic of Congo -- Figure 4A.1 Know-can-do gaps in the performance of antenatal care in Cameroon -- Figure 4A.2 Know-can-do gaps in the performance of antenatal care in the Central African Republic -- Figure 4A.3 Know-can-do gaps in the performance of antenatal care in the Democratic Republic of Congo.

Figure 4A.4 Know-can-do gaps in the performance of antenatal care in Nigeria -- Figure 4A.5 Know-can-do gaps in the performance of antenatal care in the Republic of Congo -- Figure 5.1 Key factors of performance-based financing that influence population health: An illustration -- Figure 5.2 Impacts of performance-based financing on facility physical capacity in Cameroon and Nigeria -- Figure 5.3 Impact of PBF on health worker motivation: Treatment effect (%), PBF vs. control -- Figure 5.4 Impact of PBF on health worker satisfaction: Treatment effect (%), PBF vs. control -- Figure 5.5 Impact of PBF on health worker well-being: Treatment effect (%), PBF vs. control -- Figure B5.4.1 Impact of PBF on health worker motivation: Heterogeneity in treatment effects (%), by cadre, PBF vs. control -- Figure 5.6 Impacts of performance-based financing on idle capacity-or the know-can-do gap-in Cameroon and Nigeria -- Figure 6.1 Typology and theory of change of included financial incentive interventions -- Figure B6.3.1 Search and data extraction results across all financial incentive intervention types -- Figure B6.3.2 Programs per outcome, by financial incentive intervention type -- Figure 6.2 Mean effect sizes for all incentive interventions combined -- Figure 6.3 Mean effect sizes, by intervention type -- Figure B6.6.1 Difference in mean effect size between schemes combining supply- and demand-side interventions and schemes intervening only on the supply or demand side -- Figure 6.4 Comparison of the pooled impact of performance-based and unconditional facility financing in five Sub-Saharan African countries (Cameroon, Nigeria, Rwanda, Zambia, and Zimbabwe) -- Figure 6.5 Impacts of PBF relative to DFF on idle capacity in antenatal care consultations in Cameroon and Nigeria -- Figure B6.7.1 Patient socioeconomic status, PBF, DFF, and know-can-do gaps in Nigeria.

Figure B6.7.2 Patient socioeconomic status, PBF, DFF, and know-can-do gaps in Cameroon.