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The cost-effectiveness of a PBF pilot scheme for maternal and child health services in The Gambia.: Results based on a World Bank Impact evaluation baseline survey (2014)
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: The use of Performance-based Financing (PBF) in healthcare to improve maternal and child health (MCH) is widespread in many low-middle income countries. However, evidence about the effectiveness and cost effectiveness of PBF in LMIC is mainly lacking or inconclusive.

Aim: The aim of this is to assess the cost-effectiveness of the PBF pilot scheme to improve utilization and quality of MCH services in The Gambia

Methods: The Impact Evaluation Baseline (2014) and The Gambia Demographic and Health (2013) surveys were used. Routine data on project indicators and accounts were also received. The cost for incentive payment was $107, 000 and overhead cost of $107,000. Both univariate and multivariate regressions were used to assess the association between PBF and the incentivized indicators. A difference-in-difference method was used to evaluate the impact of PBF on skilled delivery which was statistically significantly associated with PBF.

Results: Findings shows that there is 19.1% (248) additional skilled delivery as a result of the PBF scheme. The incremental cost per additional skilled delivery was $377 for incentive only payment and $2,993 for total cost.

Conclusions: The overhead cost of the project was substantial. The integration of PBF into the routine verification and supervision may become more cost effective over time. The roll out to national level may produce more promising results.

Place, publisher, year, edition, pages
2019. , p. 37
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2019:13
Keywords [en]
Performance-based financing, Results based-financing, Pay for performance, Maternal and child health services, utilization, coverage, quality of care.
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-165789OAI: oai:DiVA.org:umu-165789DiVA, id: diva2:1374918
External cooperation
The World Bank Group - Rifat Hasan
Educational program
Master's Programme in Public Health
Presentation
2019-05-22, Room A311 Caring Sciences building, Umeå University, Umeå, 15:00 (English)
Supervisors
Examiners
Available from: 2019-12-05 Created: 2019-12-03 Last updated: 2019-12-10Bibliographically approved

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
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  • Other locale
More languages
Output format
  • html
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  • asciidoc
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