Effect of Paying for Performance on Utilisation, Quality, and User Costs of Health Services in Tanzania: A Controlled Before and After Study

PloS One
Peter BinyarukaJosephine Borghi

Abstract

Despite widespread implementation across Africa, there is limited evidence of the effect of payment for performance (P4P) schemes in low income countries on the coverage of quality services and affordability, consistent with universal health coverage objectives. We examined the effect of a government P4P scheme on utilisation, quality, and user costs of health services in Tanzania. We evaluated the effects of a P4P scheme on utilisation of all maternal and child immunization services targeted by the scheme, and non-targeted general outpatient service use. We also evaluated effects on patient satisfaction with care and clinical content of antenatal care, and user costs. The evaluation was done in 150 facilities across all 7 intervention districts and 4 comparison districts with two rounds of data collection over 13-months in January 2012 and February 2013. We sampled 3000 households of women who had delivered in the 12 months prior to interview; 1500 patients attending health facilities for targeted and non-targeted services at each round of data collection. Difference-in-difference regression analysis was employed. We estimated a significant positive effect on two out of eight targeted indicators. There was an 8.2% (95% CI: 3.6...Continue Reading

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Citations

Mar 16, 2017·BMC Health Services Research·Matthieu AntonyOlivier Barthes
Jan 31, 2018·International Journal for Equity in Health·Peter BinyarukaJosephine Borghi
Apr 3, 2018·BMJ Global Health·Manuela De AllegriPaul Jacob Robyn
Aug 17, 2018·The International Journal of Health Planning and Management·Zawora Rita ZizienVincent De Brouwere
Jul 25, 2019·Global Health Research and Policy·Sophie WitterMaria Paola Bertone
Jun 14, 2018·BMC Health Services Research·Peter Binyaruka, Josephine Borghi
Oct 18, 2019·Globalization and Health·Victor ChimhutuMwifadhi Mrisho
Dec 15, 2020·Social Science & Medicine·Sosina BezuVincent Somville
May 6, 2021·The Cochrane Database of Systematic Reviews·Karin DiaconuSophie Witter
Sep 10, 2018·The Lancet Global Health·Margaret E KrukMuhammad Pate

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