Evidence on result-based financing in maternal and child health in low-and middle-income countries:a systematic review  

作　　者：Nigel James Kenny Lawson Yubraj Acharya 

机构地区：[1]Department of Health Policy and Administration,The Pennsylvania State University,University Park,PA 16801,USA [2]Translational Health Research Institute,Western Sydney University,Sydney,Australia [3]Hunter Medical Research Institute,Lot 1 Kookaburra Circuit,New Lambton Heights,NSW,Australia

出　　处：《Global Health Research and Policy》2020年第1期179-193,共15页全球健康研究与政策（英文）

摘　　要：Introduction:Result-Based Financing(RBF)is an umbrella term for financial mechanisms that link incentives to outputs or outcomes.International development agencies are promoting RBF as a viable financing approach for the realization of universal health coverage,with numerous pilot trials,particularly in low-and middle-income countries(LMICs).There is limited synthesized evidence on the performance of these mechanisms and the reasons for the lack of RBF institutionalization.This study aims to review the evidence of RBF schemes that have been scaled or institutionalized at a national level,focusing on maternal,newborn,and child health(MNCH)programming in LMICs.Methods:A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.The authors identified and reviewed country-level RBF evaluation reports for the period between January 2000 and June 2019.Data were extracted from both published and gray literature on RBF application in MNCH using a predesigned matrix.The matrix headers included country of application;program setting;coverage and duration;evaluation design and methods;outcome measures;and key findings.A content thematic analysis approach was used to synthesize the evidence and emerging issues.Results:The review identified 13 reports from 11 countries,predominantly from Sub-Saharan Africa.Performancebased financing was the most common form of RBF initiatives.The majority of evaluation designs were randomized trials.The evaluations focused on outputs,such as coverage and service utilization,rather than outcomes.RBF schemes in all 11 countries expanded their scope,either geographically or accordingly in terms of performance indicators.Furthermore,only three studies conducted a cost-effectiveness analysis,and only two included a discussion on RBF’s sustainability.Only three countries have institutionalized RBF into their national policy.On the basis of the experience of these three countries,the common enabling factors for ins

关 键 词：Result-based financing Maternal and child health care Low-and middle-income countries Pay for performance INSTITUTIONALIZATION 

分 类 号：TP1[自动化与计算机技术—控制理论与控制工程]