Decentralized facility financing versus performance-based payments in primary health care: a large-scale randomized controlled trial in Nigeria.

ABSTRACT:

Background

Health system financing presents a challenge in many developing countries. We assessed two reform packages, performance-based financing (PBF) and direct facility financing (DFF), against each other and business-as-usual for maternal and child healthcare (MCH) provision in Nigeria.

Methods

We sampled 571 facilities (269 in PBF; 302 in DFF) in 52 districts randomly assigned to PBF or DFF, and 215 facilities in 25 observable-matched control districts. PBF facilities received $2 ($1 for operating grants plus $1 for bonuses) for every $1 received by DFF facilities (operating grants alone). Both received autonomy, supervision, and enhanced community engagement, isolating the impact of additional performance-linked facility and health worker payments. Facilities and hous

SUBMITTER: Khanna M 

PROVIDER: S-EPMC8452448 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature