ArticleBMC health services research2018
Impact of results-based financing on effective obstetric care coverage: evidence from a quasi-experimental study in Malawi.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A systematic review of the effect of performance-based financing interventions on out-of-pocket expenses to improve access to, and the utilization of, maternal health services across health sectors in sub-Saharan Africa.Journal of global health · 2023Pooled it
- Evaluations of effective coverage of maternal and child health services: A systematic review.Health policy and planning · 2022Pooled it
- Paying for performance to improve the delivery of health interventions in low- and middle-income countries.The Cochrane database of systematic reviews · 2021Pooled it
- Evidence on result-based financing in maternal and child health in low- and middle-income countries: a systematic review.Global health research and policy · 2020Pooled it
- How effective coverage has been used to measure quality in maternal and child health services in sub-Saharan Africa: a scoping review.BMJ public health · 2026Article
- Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review.BMC health services research · 2024Article
- Article
- Barriers and enablers to emergency obstetric and newborn care services use in Wolaita Zone, Southern Ethiopia: a qualitative case study.BMC public health · 2022Article
- Article
- How equitable is health spending on curative services and institutional delivery in Malawi? Evidence from a quasi-longitudinal benefit incidence analysis.International journal for equity in health · 2022Article
- Implementation of a performance-based financing scheme in Malawi and resulting externalities on the quality of care of non-incentivized services.BMC pregnancy and childbirth · 2021Article
- The cost-effectiveness of using results-based financing to reduce maternal and perinatal mortality in Malawi.BMJ global health · 2020Article
- Effect of results-based financing on facility-based maternal mortality at birth: an interrupted time-series analysis with independent controls in Malawi.BMJ global health · 2019Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundResults-based financing (RBF) describes health system approaches addressing both service quality and use. Effective coverage is a metric measuring progress towards universal health coverage (UHC). Although considered a means towards achieving UHC in settings with weak health financing modalities, the impact of RBF on effective coverage has not been explicitly studied.
methodsMalawi introduced the Results-Based Financing For Maternal and Neonatal Health (RBF4MNH) Initiative in 2013 to improve quality of maternal and newborn health services at emergency obstetric care facilities. Using a quasi-experimental design, we examined the impact of the RBF4MNH on both crude and effective coverage of pregnant women across four districts during the two years following implementation.
resultsThere was no effect on crude coverage. With a larger proportion of women in intervention areas receiving more effective care over time, the overall net increase in effective coverage was 7.1%-points (p = 0.07). The strongest impact on effective coverage (31.0%-point increase, p = 0.02) occurred only at lower cut-off level (60% of maximum score) of obstetric care effectiveness. Design-specific and wider health system factors likely limited the program's potential to produce stronger effects.
conclusionThe RBF4MNH improved effective coverage of pregnant women and seems to be a promising reform approach towards reaching UHC. Given the short study period, the full potential of the current RBF scheme has likely not yet been reached.
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