Rewarding Provider Performance to Enable a Healthy Start to Life
Rewarding Provider Performance to Enable a Healthy Start to Life

Author: Paul J. Gertler

Publisher:

Published: 2017

Total Pages: 37

ISBN-13:

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Argentina's Plan Nacer provides insurance for maternal and child health care to uninsured families. The program allocates funding to provinces based on enrollment of beneficiaries and adds performance incentives based on indicators of the use and quality of maternal and child health care services and health outcomes. The provinces use these resources to pay health facilities to provide maternal and child health care services to beneficiaries. This paper analyzes the impact of Plan Nacer on birth outcomes. The analysis uses data from the universe of birth records in seven Argentine provinces for 2004 to 2008 and exploits the geographic phasing in of Plan Nacer over time. The paper finds that the program increases the use and quality of prenatal care as measured by the number of visits and the probability of receiving a tetanus vaccine. Beneficiaries' probability of low birth-weight is estimated to be reduced by 19 percent. Beneficiaries have a 74 percent lower chance of in-hospital neonatal mortality in larger facilities and approximately half this reduction comes from preventing low birth weight and half from better postnatal care. The analysis finds that the cost of saving a disability-adjusted life year through the program was $814, which is highly cost-effective compared with Argentina's $6,075 gross domestic product per capita over this period. Although there are small negative spillover effects on prenatal care utilization of non-beneficiary populations in clinics covered by Plan Nacer, nospillover is found on their birth outcomes.

Rewarding Provider Performance to Enable a Healthy Start to Life
Rewarding Provider Performance to Enable a Healthy Start to Life

Author: Paul Gertler

Publisher:

Published: 2014

Total Pages: 37

ISBN-13:

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Argentina's Plan Nacer provides insurance for maternal and child health care to uninsured families. The program allocates funding to provinces based on enrollment of beneficiaries and adds performance incentives based on indicators of the use and quality of maternal and child health care services and health outcomes. The provinces use these resources to pay health facilities to provide maternal and child health care services to beneficiaries. This paper analyzes the impact of Plan Nacer on birth outcomes. The analysis uses data from the universe of birth records in seven Argentine provinces for 2004 to 2008 and exploits the geographic phasing in of Plan Nacer over time. The paper finds that the program increases the use and quality of prenatal care as measured by the number of visits and the probability of receiving a tetanus vaccine. Beneficiaries' probability of low birth-weight is estimated to be reduced by 19 percent. Beneficiaries have a 74 percent lower chance of in-hospital neonatal mortality in larger facilities and approximately half this reduction comes from preventing low birth weight and half from better postnatal care.

What's In, What's Out
What's In, What's Out

Author: Amanda Glassman

Publisher: Brookings Institution Press

Published: 2017-10-10

Total Pages: 449

ISBN-13: 1944691057

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Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.

Improving Effective Coverage in Health
Improving Effective Coverage in Health

Author: Damien de Walque

Publisher: World Bank Publications

Published: 2022-05-18

Total Pages: 338

ISBN-13: 1464818797

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In many low- and middle-income countries, health coverage has improved dramatically in the past two decades, but health outcomes have not. As such, effective coverage—a measure of service delivery that meets a minimum standard of quality—remains unacceptably low. Improving Effective Coverage in Health examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF), a package reform that typically includes performance pay to frontline health workers as well as facility autonomy, transparency, and community engagement. This Policy Research Report draws on a rich set of rigorous studies and new analysis. When compared with business-as-usual, in low-income settings with centralized health systems PBF can result in substantial gains in effective coverage. However, the relative benefits of PBF—the performance pay component in particular—are less clear when it is compared with two alternative approaches, direct facility financing, which provides operating budgets to frontline health services with facility autonomy on allocation, but not performance pay, and demand-side financial support for health services (that is, conditional cash transfers and vouchers). Although PBF often results in improvements on the margins, closing the substantial gaps in effective health coverage is not yet within reach for many countries. Nonetheless, important lessons and experiences from the rollout of PBF over the past decade can guide health financing into the future. In particular, to be successful, health financing reform may need to pivot from performance pay while retaining the elements of direct facility financing, autonomy, transparency, and community engagement.

Millions Saved
Millions Saved

Author: Amanda Glassman

Publisher: Brookings Institution Press

Published: 2016-05-24

Total Pages: 414

ISBN-13: 1933286938

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Over the past fifteen years, people in low- and middle-income countries have experienced a health revolution—one that has created new opportunities and brought new challenges. It is a revolution that keeps mothers and babies alive, helps children grow, and enables adults to thrive. Millions Saved: New Cases of Proven Success in Global Health chronicles the global health revolution from the ground up, showcasing twenty-two local, national, and regional health programs that have been part of this global change. The book profiles eighteen remarkable cases in which large-scale efforts to improve health in low- and middle-income countries succeeded, and four examples of promising interventions that fell short of their health targets when scaled-up in real world conditions. Each case demonstrates how much effort—and sometimes luck—is required to fight illness and sustain good health. The cases are grouped into four main categories, reflecting the diversity of strategies to improve population health in low-and middle-income countries: rolling out medicines and technologies; expanding access to health services; targeting cash transfers to improve health; and promoting population-wide behavior change to decrease risk. The programs covered also come from various regions around the world: seven from sub-Saharan Africa, six from Latin America and the Caribbean, five from East and Southeast Asia, and four from South Asia.

Better Spending for Better Lives
Better Spending for Better Lives

Author: Alejandro Izquierdo

Publisher: Inter-American Development Bank

Published: 2018-09-16

Total Pages: 453

ISBN-13: 1597823317

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How can this puzzle of larger demands and fiscal strengthening be solved? This edition of the development in the Americas (DIA) report focuses precisely on this question. The book suggests that the answer is about fiscal efficiency and smart spending rather than the standard solution of across-the-board spending cuts to achieve fiscal sustainability— sometimes at great cost for society. It is about doing more with less. · Analysis of government spending in Latin America and the Caribbean reveals widespread waste and inefficiencies that could be as large as 4.4 percent of the region’s GDP, showing there is ample room to improve basic services without necessarily spending more resources. · The publication argues against across-the-board cuts. It looks at whether countries spend too much or too little on different priorities, whether they invest enough to ensure a better future, and whether those expenditures make inequality better or worse. · Along with the diagnosis, the report offers several policy recommendations on how to improve the efficiency of government spending.

When Democracies Deliver
When Democracies Deliver

Author: Katherine Bersch

Publisher: Cambridge University Press

Published: 2019-01-17

Total Pages: 237

ISBN-13: 1108644902

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Why do governance reforms in developing democracies so often fail, and when might they succeed? When Democracies Deliver offers a dynamic framework for assessing the effectiveness and durability of policy change. Drawing on detailed analyses of public sector reforms in Brazil and Argentina, this book challenges conventional wisdom to reveal that incremental changes sequenced over time prove more effective in promoting accountability, increasing transparency, and strengthening institutions than comprehensive overhauls pushed through by political will. Developing an innovative theory that integrates cognitive-psychological insights about decision making with research on institutional change, Katherine Bersch shows how political and organizational factors can shape reform strategies and information processing. Through extensive interviews and field research, Bersch traces how two competing strategies have determined the different trajectories of institutions responsible for government contracting in health care and transportation. When Democracies Deliver offers a fresh insight on the perils of powering and the benefits of gradual reform.

Development Effectiveness Overview (DEO) 2018
Development Effectiveness Overview (DEO) 2018

Author: Inter American Development Bank

Publisher: Inter-American Development Bank

Published: 2018-09-13

Total Pages: 93

ISBN-13:

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The Development Effectiveness Overview (DEO) is an annual report produced by the IDBG to show the results and impact of its work in Latin America and the Caribbean. It reports on the IDBG's contributions towards the development of its 26 borrowing member countries in Latin America and the Caribbean, holding the IDBG accountable to its shareholders, partners and beneficiaries.

Améliorer la couverture effective en matière de santé
Améliorer la couverture effective en matière de santé

Author: Damien de Walque

Publisher: World Bank Publications

Published: 2022-10-30

Total Pages: 352

ISBN-13: 1464818967

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Dans de nombreux pays à faible revenu et à revenu intermédiaire, la couverture sanitaire s’est considérablement améliorée au cours des deux dernières décennies, mais pas les résultats en matière de santé. Ainsi, la couverture effective — une mesure de la prestation de services qui répond à une norme minimale de qualité — demeure à un niveau inacceptable. Le rapport Améliorer la couverture effective en matière de santé examine une approche particulière visant à améliorer la couverture effective : les incitations financières sous la forme d’un financement basé sur la performance (FBP), une réforme globale qui comprend généralement la rémunération liée à la performance pour les agents de santé de première ligne ainsi que l’autonomie des établissements, la transparence et l’engagement communautaire. Ce rapport de recherche s’appuie sur un vaste ensemble d’études rigoureuses et de nouvelles analyses. Par rapport au statu quo, dans les pays à faible revenu dotés de systèmes de santé centralisés, le FBP peut entraîner des gains substantiels en matière de couverture effective. Toutefois, les avantages relatifs du FBP — la composante rémunération liée à la performance en particulier — sont moins clairs lorsqu’il est comparé à deux autres approches, à savoir : le financement direct des établissements, qui permet d’octroyer des budgets de fonctionnement aux services de santé de première ligne en accordant aux établissements l’autonomie en matière d’allocations budgétaires, mais sans rémunération liée à la performance ; et le soutien financier lié à la demande pour les services de santé (c’est-à -dire les transferts monétaires conditionnels et les vouchers). Bien que le FBP se traduise souvent par des améliorations marginales, combler les lacunes importantes de la couverture sanitaire effective n’est pas encore à la portée de nombreux pays. Néanmoins, d’importantes leçons et expériences tirées de la mise en oeuvre du FBP au cours de la dernière décennie peuvent orienter le financement de la santé à l’avenir. En particulier, pour réussir, la réforme du financement de la santé devra sans doute moins se focaliser sur la rémunération à la performance tout en conservant les éléments de financement direct des établissements, l’autonomie, la transparence et l’engagement communautaire.