ReviewBMJ global health2022
Reviewing the evidence on health financing for effective coverage: do financial incentives work?
Review in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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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
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Performance and challenges of malaria rapid diagnostic tests in endemic regions of Africa.Scientific reports · 2025Pooled it
- Economic evaluation of financial incentives for maternal and child health in the Democratic Republic of the Congo (DRC): a decision-tree modelling based on a cluster randomized controlled trial.Global health research and policy · 2025Trial
- Boosting health provider performance with non-financial incentives: A cluster-randomized controlled trial in Tanzania.PloS one · 2025Trial
- Making experts accountable in global health.BMJ global health · 2026Article
- Digital payments of health workers within vaccination campaigns: a mixed-methods study in Chad.BMJ global health · 2026Article
- Using causal loop diagrams to explore the maternal and child health system response to payment for performance in Zambia, and it's generalisability across settings.SSM - health systems · 2025Article
- Know-do gaps in the clinical management of childhood illness: evidence from three countries in sub-Saharan Africa.BMC public health · 2025Observational
- The effect of performance-based financing interventions on health worker motivation and job satisfaction: experimental evidence from six national pilots.Health policy and planning · 2025Article
- Identifying the active ingredients in payment for performance programmes using system dynamics modelling.SSM - health systems · 2025Article
- What influences the impact of health financing reforms? Using qualitative comparative analysis to identify patterns in health financing systems and their effects on financial protection.SSM - health systems · 2025Review
- Addressing skilled birth attendants' needs of primary healthcare facilities in Nigeria using the human resources for health solutions model.Discover health systems · 2025Review
- Article
- Perceptions of healthcare finance and system quality among Nigerian healthcare workers.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
- The politics of health system quality: how to ignite demand.BMJ (Clinical research ed.) · 2023Article
- The effectiveness of pay-for-performance contracts with non-governmental organizations in Afghanistan - results of a controlled interrupted time series analysis.BMC health services research · 2023Article
- Examining the Effect of Maternity Cash Incentives Under Nepal's Aama Program on the Continuum of Maternity Care: A Difference-in-Differences Analysis of NDHS 2011 to 2022.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The widening gap between improving healthcare coverage rates and stagnating health outcomes across low-income and middle-income countries highlights the need for investments in quality of care, in addition to access. New research, presented in a World Bank report, examines one type of relevant policy reform: performance-based financing (PBF), which is a package reform that always includes performance pay to front-line health workers and often also provides facility autonomy, transparency and community engagement. A large body of rigorous studies and new analysis show that in under-resourced, centralised health systems, PBF can result in gains to service utilisation, but only has limited impacts on quality. Even the relative benefits of PBF on service utilisation are less clear when compared with (1) direct facility financing which provides front-line facilities with operating budgets and provider autonomy, but not performance pay and (2) demand-side financial support for health services (ie, conditional cash transfers and vouchers). Thus, the central component of PBF-the performance pay-appears to add little value over flexible payment systems and provider autonomy. The analysis shows that this lack of impact is unsurprising because most of the constraints to improving quality do not lie with the health worker in these settings. While PBF was conceived as a complex package 'blueprint', we review the evidence to conclude that only some elements seem to make sense. To improve quality of care, health financing should pivot from performance pay while retaining the elements of direct facility financing, autonomy, transparency and community engagement.
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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.