Understanding the maternal and child health system response to payment for performance in Tanzania using a causal loop diagram approach.

ABSTRACT: Payment for performance (P4P) has been employed in low and middle-income (LMIC) countries to improve quality and coverage of maternal and child health (MCH) services. However, there is a lack of consensus on how P4P affects health systems. There is a need to evaluate P4P effects on health systems using methods suitable for evaluating complex systems. We developed a causal loop diagram (CLD) to further understand the pathways to impact of P4P on delivery and uptake of MCH services in Tanzania. The CLD was developed and validated using qualitative data from a process evaluation of a P4P scheme in Tanzania, with additional stakeholder dialogue sought to strengthen confidence in the diagram. The CLD maps the interacting mechanisms involved in provider achievement of targets, reporting of healt

SUBMITTER: Cassidy R 

PROVIDER: S-EPMC8434440 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature