ArticleBMC health services research2015
The effect of performance-based financing on illness, care-seeking and treatment among children: an impact evaluation in Rwanda.
Article in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Paying for performance to improve the delivery of health interventions in low- and middle-income countries.The Cochrane database of systematic reviews · 2021Pooled it
- How are pay-for-performance schemes in healthcare designed in low- and middle-income countries? Typology and systematic literature review.BMC health services research · 2020Pooled it
- Active Purchasing: Empirical Insights From the Dutch Healthcare System and Lessons for Low- and Middle-Income Countries Comment on "Measuring Active Purchasing in Healthcare: Analysing Reallocations of Funds Between Providers to Evaluate Purchasing Systems Performance in the Netherlands".International journal of health policy and management · 2025Article
- Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review.BMJ open · 2023Article
- Cost-Effectiveness of Expanding Access to Primary Health Care in Rural Rwanda by Adding Laboratory-Equipped Health Posts: A Prospective, Controlled Study.The American journal of tropical medicine and hygiene · 2023Article
- Discontinuation of performance-based financing in primary health care: impact on family planning and maternal and child health.International journal of health economics and management · 2023Article
- Exploring the roles of players in strategic purchasing for healthcare in Africa-a scoping review.Health policy and planning · 2023Article
- Assessment of utilisation of government programmes and services by pregnant women in India.PloS one · 2023Article
- Article
- Examining the Implementation of the Performance-Based Financing Equity Strategy in Improving Access and Utilization of Maternal Health Services in Cameroon: A Qualitative Study.International journal of environmental research and public health · 2022Article
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- Article
- Unintended effects of Janani Suraksha Yojana on maternal care in India.SSM - population health · 2020Article
- Improvement of the quality payment program by improving data reporting process: an action research.BMC health services research · 2018Article
- Who benefits from increased service utilisation? Examining the distributional effects of payment for performance in Tanzania.International journal for equity in health · 2018Article
- A study on the implementation fidelity of the performance-based financing policy in Burkina Faso after 12 months.Archives of public health = Archives belges de sante publique · 2018Article
- Performance-based financing in low-income and middle-income countries: isn't it time for a rethink?BMJ global health · 2018Review
- The effect of a performance-based financing program on HIV and maternal/child health services in Mozambique-an impact evaluation.Health policy and planning · 2017Article
- Performance-based financing contributes to the resilience of health services affected by the Liberian Ebola outbreak.Public health action · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPerformance-based financing (PBF) strategies are promoted as a supply-side, results-based financing mechanism to improve primary health care. This study estimated the effects of Rwanda's PBF program on less-incentivized child health services and examined the differential program impact by household poverty.
methodsDistricts were allocated to intervention and comparison for PBF implementation in Rwanda. Using Demographic Health Survey data from 2005 to 2007-08, a community-level panel dataset of 5781 children less than 5 years of age from intervention and comparison districts was created. The impacts of PBF on reported childhood illness, facility care-seeking, and treatment received were estimated using a difference-in-differences model with community fixed effects. An interaction term between poverty and the program was estimated to identify the differential effect of PBF among children from poorer families.
resultsThere was no measurable difference in estimated probability of reporting illness with diarrhea, fever or acute respiratory infections between the intervention and comparison groups. Seeking care at a facility for these illnesses increased over time, however no differential effect by PBF was seen. The estimated effect of PBF on receipt of treatment for poor children is 45 percentage points higher (p = 0.047) compared to the non-poor children seeking care for diarrhea or fever.
conclusionsPBF, a supply-side incentive program, improved the quality of treatment received by poor children conditional on patients seeking care, but it did not impact the propensity to seek care. These findings provide additional evidence that PBF incentivizes the critical role staff play in assuring quality services, but does little to influence consumer demand for these services. Efforts to improve child health need to address both supply and demand, with additional attention to barriers due to poverty if equity in service use is a concern.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.