Pay for Performance

Pay-for-performance (P4P) is a strategy that links payment to results. Health sector stakeholders, from international donors to government and health system policymakers, program managers, and health care providers increasingly see P4P as an important complement to investing in inputs such as buildings, drugs, and training when working to strengthen health systems and achieve the Millennium Development Goals (MDGs) and other targets that represent better health status for people. By providing financial incentives that encourage work toward agreed-upon results, P4P helps solve challenges such as increasing the quality of, as well as access to and use of health services. Many developing countries are currently piloting or scaling up P4P programs to meet MDGs and other health indicators.

Health Systems 20/20 is engaged in P4P efforts globally, having led workshops in Asia and Africa and developed a P4P Blueprint Guide, which assists countries to think through and design a country-specific P4P scheme. Most recent efforts include development of a P4P case study series. As part of this series, HS2020 has collected scheme-specific P4P tools, which range from sample vouchers to examples of contracts, from guidance on how to determine payment recipients to sample indicators.

We invite you to join an on-line Performance Based Incentives Network (PBIN), a place where a wide range of participants from implementers from around the globe, academics and donors post papers, news, and share information on P4P. We also welcome learning more about P4P efforts that are underway where you work.

Health Systems 20/20 and Pay for Performance (P4P) Brief

Key P4P Activities

Case Studies

• Belize
• Benin
• Brazil
• Burundi
• Democratic Republic of Congo
• Egypt
• Ethiopia
• India
• Kenya (Voucher scheme, full program perspective; Voucher scheme, service providing NGO perspective)
• Pakistan
• Philippines
• Tanzania
• Uganda

Tools

• Public sector guidance from central level to lower levels on accrediting private sector facilities or contracting with district-level health facilities
• Sample contracts and Memoranda of Understanding (MoUs) between governments and public sector facilities, between governments and private sector facilities or between private non-profits and individual providers
• Sample indicators: quantitative and qualitative
• Methods to determine payment recipients (examples of poverty grading tools and of beneficiary identification forms)
• Examples of voucher claim forms (for clients and providers)
• Job descriptions for individuals involved in P4P (community health workers, volunteer outreach workers, etc.)
• Workshops in Asia and Africa where the P4P Blueprint Guide was put into practice