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Performance-Based Incentives for Health: Six Years of Results from Supply-Side Programs in Haiti

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Listed:
  • Rena Eichler
  • Paul Auxila
  • Uder Antoine
  • Bernateau Desmangles

Abstract

USAID launched a project in 1995 to deliver basic health services in Haiti. The project began by reimbursing contracted NGOs for documented expenditures or inputs. In 1999, payment was changed to being based partly on attaining performance targets or outputs. The project also provided technical assistance to the NGOs, along with opportunities to participate in an NGO network and other cross-fertilization activities. Remarkable improvements in key health indicators have been achieved in the six years since payment for performance was phased in. Although it is difficult to isolate the effects of performance-based payment on these improved indicators from the efforts aimed at strengthening NGOs and other factors, panel regression results suggest that the new payment incentives were responsible for considerable improvements in both immunization coverage and attended deliveries. Results for prenatal and postnatal care were less significant, perhaps suggesting a strong patient behavioral element that is not under the influence of provider actions.

Suggested Citation

  • Rena Eichler & Paul Auxila & Uder Antoine & Bernateau Desmangles, 2007. "Performance-Based Incentives for Health: Six Years of Results from Supply-Side Programs in Haiti," Working Papers 121, Center for Global Development.
    • Handle: RePEc:cgd:wpaper:121
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    File URL: http://www.cgdev.org/files/13543_file_Haiti_Incentives.pdf
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    References listed on IDEAS

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    1. Rogerson, William P, 1985. "The First-Order Approach to Principal-Agent Problems," Econometrica, Econometric Society, vol. 53(6), pages 1357-1367, November.
    2. Rena Eichler & Paul Auxila & John Pollock, 2001. "Output-Based Health Care : Paying for Performance in Haiti," World Bank Publications - Reports 11370, The World Bank Group.
    3. Grossman, Sanford J & Hart, Oliver D, 1983. "An Analysis of the Principal-Agent Problem," Econometrica, Econometric Society, vol. 51(1), pages 7-45, January.
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    Cited by:

    1. Martin Chalkley & Andrew J. Mirelman & Luigi Siciliani & Marc Suhrcke & Peter Berman, 2020. "Paying for Performance for Health Care in Low- and Middle-Income Countries: An Economic Perspective," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 6, pages 157-190, World Scientific Publishing Co. Pte. Ltd..
    2. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.
    3. Charles Kenny, William Savedoff, 2013. "Can Results-Based Payments Reduce Corruption?-Working Paper 345," Working Papers 345, Center for Global Development.
    4. Aryankhesal, Aidin & Sheldon, Trevor A. & Mannion, Russell, 2014. "Impact of the Iranian hospital grading system on hospitals’ adherence to audited standards: An examination of possible mechanisms," Health Policy, Elsevier, vol. 115(2), pages 206-214.
    5. 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.
    6. Caryl Feldacker & Aaron F Bochner & Amy Herman-Roloff & Marrianne Holec & Vernon Murenje & Abby Stepaniak & Sinokuthemba Xaba & Mufata Tshimanga & Vuyelwa Chitimbire & Shingirai Makaure & Joseph Hove , 2017. "Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-15, March.
    7. Hapsatou Touré & Martine Audibert & François Dabis, 2010. "To what extent could performance-based schemes help increase the effectiveness of prevention of mother-to-child transmission of HIV (PMTCT) programs in resource-limited settings? A summary of the publ," Post-Print inserm-00617221, HAL.

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    Keywords

    Health; Haiti;

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