Towards a more balanced rethinking of performance-based financing

By Maarten Oranje In a recently published paper in BMJ Global Health, a group of authors (Paul et al) challenged overly optimistic views on performance-based financing (PBF) in the health sector, and its implementation in low- and middle-income countries. While some of the issues they raised are legitimate, the paper paints an overall picture of […]

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Rethinking performance-based financing: sustainability must be part of the debate

By Priscilla N Owusu In the recent BMJ Global Health article Paul et al critique the notion that performance-based financing (PBF) is an effective approach to improving health service delivery in low- and middle-income countries (LMICs). They do so by highlighting concerns about the mixed evidence supporting the efficacy of the intervention.  Using Rwanda as […]

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The baby and the bathwater: can we have a more constructive debate on performance-based financing?

By Godelieve van Heteren Paul et al’s critique In a recent paper in BMJ Global Health, 24 authors (Paul et al) – the majority of whom are French-speaking academics and consultants from northern countries – declared that performance-based financing (PBF) in low- and middle-income country (LMIC) health systems needs an urgent rethink. They claim it is […]

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R N Karuga: “Building a resilient and responsive health system needs strong community support”

“Forget about these people in the national office,” said Maria (not her real name). “They are not in touch with reality!” Maria is a district health manager in Kenya. This was her response when I asked how closely she works with the national Ministry of Health in delivering community health services. In 2013, the governance […]

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