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Why performance-based contracting failed in Uganda – An “open-box” evaluation of a complex health system intervention

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  • Ssengooba, Freddie
  • McPake, Barbara
  • Palmer, Natasha

Abstract

Performance-based contracting (PBC) is a tool that links rewards to attainment of measurable performance targets. Significant problems remain in the methods used to evaluate this tool. The primary focus of evaluations on the effects of PBC (black-box) and less attention to how these effects arise (open-box) generates suboptimal policy learning. A black-box impact evaluation of PBC pilot by the Development Research Group of the World Bank (DRG) and the Ministry of Health (MOH) concluded that PBC was ineffective.

Suggested Citation

  • Ssengooba, Freddie & McPake, Barbara & Palmer, Natasha, 2012. "Why performance-based contracting failed in Uganda – An “open-box” evaluation of a complex health system intervention," Social Science & Medicine, Elsevier, vol. 75(2), pages 377-383.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:2:p:377-383
    DOI: 10.1016/j.socscimed.2012.02.050
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    References listed on IDEAS

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    Cited by:

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    2. Lohmann, Julia & Houlfort, Nathalie & De Allegri, Manuela, 2016. "Crowding out or no crowding out? A Self-Determination Theory approach to health worker motivation in performance-based financing," Social Science & Medicine, Elsevier, vol. 169(C), pages 1-8.
    3. Magrath, Priscilla & Nichter, Mark, 2012. "Paying for performance and the social relations of health care provision: An anthropological perspective," Social Science & Medicine, Elsevier, vol. 75(10), pages 1778-1785.
    4. Duchoslav, Jan & Cecchi, Francesco, 2019. "Do incentives matter when working for god? The impact of performance-based financing on faith-based healthcare in Uganda," World Development, Elsevier, vol. 113(C), pages 309-319.
    5. Walton, Mat, 2014. "Applying complexity theory: A review to inform evaluation design," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 119-126.
    6. Ogundeji, Yewande Kofoworola & Bland, John Martin & Sheldon, Trevor Andrew, 2016. "The effectiveness of payment for performance in health care: A meta-analysis and exploration of variation in outcomes," Health Policy, Elsevier, vol. 120(10), pages 1141-1150.
    7. Cong Wang & Fuguo Cao & Jing Yang, 2021. "Whole-process performance management of government procurement: a quantitative analysis of 58 policy texts," SN Business & Economics, Springer, vol. 1(12), pages 1-32, December.
    8. Khim, Keovathanak & Annear, Peter Leslie, 2013. "Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia," Social Science & Medicine, Elsevier, vol. 96(C), pages 241-249.
    9. Singh, Neha S. & Kovacs, Roxanne J. & Cassidy, Rachel & Kristensen, Søren R. & Borghi, Josephine & Brown, Garrett W., 2021. "A realist review to assess for whom, under what conditions and how pay for performance programmes work in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 270(C).
    10. Mayumana, Iddy & Borghi, Jo & Anselmi, Laura & Mamdani, Masuma & Lange, Siri, 2017. "Effects of Payment for Performance on accountability mechanisms: Evidence from Pwani, Tanzania," Social Science & Medicine, Elsevier, vol. 179(C), pages 61-73.
    11. Maria Paola Bertone & Jean-Benoît Falisse & Giuliano Russo & Sophie Witter, 2018. "Context matters (but how and why?) A hypothesis-led literature review of performance based financing in fragile and conflict-affected health systems," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-27, April.

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