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In Tanzania, the many costs of pay-for-performance leave open to debate whether the strategy is cost-effective

Borghi, Josephine and Little, Richard and Binyaruka, Peter and Patouillard, Edith and Kuwawenaruwa, August. (2015) In Tanzania, the many costs of pay-for-performance leave open to debate whether the strategy is cost-effective. Health affairs, Vol. 34, H. 3. S. 406-414.

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Official URL: http://edoc.unibas.ch/dok/A6357853

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Abstract

Pay-for-performance programs in health care are widespread in low- and middle-income countries. However, there are no studies of these programs' costs or cost-effectiveness. We conducted a cost-effectiveness analysis of a pay-for-performance pilot program in Tanzania and modeled costs of its national expansion. We reviewed project accounts and reports, interviewed key stakeholders, and derived outcomes from a controlled before-and-after study. In 2012 US dollars, the financial cost of the pay-for-performance pilot was $1.2 million, and the economic cost was $2.3 million. The incremental cost per additional facility-based birth ranged from $540 to $907 in the pilot and from $94 to $261 for a national program. In a low-income setting, the costs of managing the program and generating and verifying performance data were substantial. Pay-for-performance programs can stimulate the generation and use of health information by health workers and managers for strategic planning purposes, but the time involved could divert attention from service delivery. Pay-for-performance programs may become more cost-effective when integrated into routine systems over time.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Interventions (Lengeler)
UniBasel Contributors:Patouillard, Edith
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:Health Affairs
ISSN:0278-2715
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:10 Apr 2015 09:13
Deposited On:10 Apr 2015 09:13

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