Population Council Research that makes a difference

XXVII IUSSP International Population Conference
26–31 August

Abstract

"A pay-for-performance innovation for improving maternal health services in Bangladesh"
Ubaidur Rob, Md. Noorunnabi Talukder, Laila Rahman, Ismat Ara Hena, Mst. Farhana Akter, and Nargis Sultana

In Bangladesh, low use of facilities for maternal health services in rural areas has been a critical challenge to the health system in reducing maternal mortality. Health facilities in rural areas operate at less than their capacity due to shortage and sub-optimal performance of service providers. An operations research study was conducted to test the feasibility of pay-for-performance (P4P) approach, through which financial incentive was provided to motivate the team of managers, direct and indirect providers, and administrative and support staff of a facility for achieving both quantity and quality targets on maternal health services set for the institution on quarterly basis. Performance of a facility was measured using service statistics and quality assessment reports. An external body with an obstetrician, an anesthesiologist and a pediatrician was formed to assess the facility performance every three months and subsequently incentive was paid to the eligible facility. Performance-based incentive motivated additional efforts which caused to increase service volume remarkably, and the facilities also succeeded in improving quality of services. Performance-based incentive is required until it significantly increases the rate of institutional delivery, a key requirement to reduce maternal mortality.

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