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.

ABSTRACT: This study investigates the generalisability of pathways depicted by causal loop diagrams (CLDs) in payment for performance (P4P) schemes by adapting and validating the Tanzanian CLDs to the Zambian context. Specifically, it explores whether the health system pathways represented by CLDs, are consistent across different settings and how variations in programme design and local context influence these pathways. Using a five-stage approach, the study adapted the Tanzanian CLDs to reflect the Zambian P4P programme context, validating them through stakeholder interviews, workshops, and secondary qualitative data. The findings show that while the overarching pathways influencing P4P outcomes are similar, differences in programme design and contextual factors shape their intensity and impact. No

SUBMITTER: Chama-Chiliba CM 

PROVIDER: S-EPMC12678228 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature