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Using provider performance incentives to increase HIV testing and counseling services in Rwanda

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  • de Walque, Damien
  • Gertler, Paul J
  • Bautista-Arredondo, Sergio
  • Kwan, Ada
  • Vermeersch, Christel
  • de Dieu Bizimana, Jean
  • Binagwaho, Agnes
  • Condo, Jeanine

Abstract

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by specific utilization and quality of care indicators. In 2006, Rwanda began a paying for performance scheme to improve health services delivery, including HIV/AIDS services. This study examines the scheme's impact on individual and couples HIV testing and counseling and using data from a prospective quasi-experimental design. The study finds a positive impact of paying for performance with an increase of 6.1 percentage points in the probability of individuals having ever been tested. This positive impact is stronger for married individuals: 10.2 percentage points. The results also indicate larger impacts of paying for performance on the likelihood that the respondent reports both partners have ever been tested, especially among discordant couples (14.7 percentage point increase) in which only one of the partners is HIV positive.

Suggested Citation

  • de Walque, Damien & Gertler, Paul J & Bautista-Arredondo, Sergio & Kwan, Ada & Vermeersch, Christel & de Dieu Bizimana, Jean & Binagwaho, Agnes & Condo, Jeanine, 2013. "Using provider performance incentives to increase HIV testing and counseling services in Rwanda," Policy Research Working Paper Series 6364, The World Bank.
    • Handle: RePEc:wbk:wbrwps:6364
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    References listed on IDEAS

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    Cited by:

    1. Derksen, Laura & Muula, Adamson & van Oosterhout, Joep, 2022. "Love in the time of HIV: How beliefs about externalities impact health behavior," Journal of Development Economics, Elsevier, vol. 159(C).
    2. Ahmad Reshad Osmani, 2021. "Conditional Cash Incentive and Use of Health Care Services: New Evidence from a Household Experiment," Journal of Family and Economic Issues, Springer, vol. 42(3), pages 518-532, September.
    3. Singh, Prakarsh & Mitra, Sandip, 2017. "Incentives, information and malnutrition: Evidence from an experiment in India," European Economic Review, Elsevier, vol. 93(C), pages 24-46.
    4. Lina Maria Ellegård & Jens Dietrichson & Anders Anell, 2018. "Can pay‐for‐performance to primary care providers stimulate appropriate use of antibiotics?," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 39-54, January.
    5. Grant Miller & Kimberly Singer Babiarz, 2013. "Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs," NBER Working Papers 18932, National Bureau of Economic Research, Inc.
    6. Nicholas Stacey & Andrew Mirelman & Noemi Kreif & Marc Suhrcke & Karen Hofman & Ijeoma Edoka, 2021. "Facility standards and the quality of public sector primary care: Evidence from South Africa's “Ideal Clinics” program," Health Economics, John Wiley & Sons, Ltd., vol. 30(7), pages 1543-1558, July.
    7. Ngo, Diana K.L. & Bauhoff, Sebastian, 2021. "The medium-run and scale-up effects of performance-based financing: An extension of Rwanda’s 2006 trial using secondary data," World Development, Elsevier, vol. 139(C).
    8. Singh, Prakarsh & Masters, William A., 2020. "Performance bonuses in the public sector: Winner-take-all prizes versus proportional payments to reduce child malnutrition in India," Journal of Development Economics, Elsevier, vol. 146(C).
    9. Jacky MATHONNAT & Aurore PELISSIER, 2017. "How a Results-Based Financing approach can contribute to the health Sustainable Development Goals - Policy-oriented lessons: what we know, what we need to know and don’t yet know," Working Papers P204, FERDI.
    10. Gil Shapira & Ina Kalisa & Jeanine Condo & James Humuza & Cathy Mugeni & Denis Nkunda & Jeanette Walldorf, 2018. "Going beyond incentivizing formal health providers: Evidence from the Rwanda Community Performance‐Based Financing program," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 2087-2106, December.
    11. Bernal, Pedro & Martinez, Sebastian, 2020. "In-kind incentives and health worker performance: Experimental evidence from El Salvador," Journal of Health Economics, Elsevier, vol. 70(C).
    12. Singh, Neha S. & Kovacs, Roxanne J. & Cassidy, Rachel & Kristensen, Søren R. & Borghi, Josephine & Brown, Garrett W., 2021. "A realist review to assess for whom, under what conditions and how pay for performance programmes work in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 270(C).
    13. Xiaojie Sun & Xiaoyun Liu & Qiang Sun & Winnie Yip & Adam Wagstaff & Qingyue Meng, 2016. "The Impact of a Pay‐for‐Performance Scheme on Prescription Quality in Rural China," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 706-722, June.
    14. Singh, Prakarsh & Masters, William A., 2017. "Impact of caregiver incentives on child health: Evidence from an experiment with Anganwadi workers in India," Journal of Health Economics, Elsevier, vol. 55(C), pages 219-231.
    15. Abbott, Pamela & Sapsford, Roger & Binagwaho, Agnes, 2017. "Learning from Success: How Rwanda Achieved the Millennium Development Goals for Health," World Development, Elsevier, vol. 92(C), pages 103-116.
    16. Tisamarie B. Sherry & Sebastian Bauhoff & Manoj Mohanan, 2017. "Multitasking and Heterogeneous Treatment Effects in Pay-for-Performance in Health Care: Evidence from Rwanda," American Journal of Health Economics, MIT Press, vol. 3(2), pages 192-226, Spring.
    17. Groß, Mona & Hennig-Schmidt, Heike & Wiesen, Daniel, 2023. "Personality and physician performance pay: Evidence from a behavioral experiment in health," HERO Online Working Paper Series 2023:5, University of Oslo, Health Economics Research Programme.
    18. Sergio Bautista-Arredondo & Gina La Hera-Fuentes & David Contreras-Loya & Ada Kwan & S Janae Van Buren & Ogbonna O Amanze & Akinyemi Atobatele & Adedayo Adeyemi & Emmanuel Abatta & Kayode M Ogungbemi , 2018. "Efficiency of HIV services in Nigeria: Determinants of unit cost variation of HIV counseling and testing and prevention of mother-to-child transmission interventions," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-19, September.
    19. Caryl Feldacker & Aaron F Bochner & Amy Herman-Roloff & Marrianne Holec & Vernon Murenje & Abby Stepaniak & Sinokuthemba Xaba & Mufata Tshimanga & Vuyelwa Chitimbire & Shingirai Makaure & Joseph Hove , 2017. "Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-15, March.
    20. Dunsch, Felipe Alexander & Velenyi, Edit, 2019. "Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment," SocArXiv bqx5k, Center for Open Science.

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    More about this item

    Keywords

    Health Monitoring&Evaluation; Disease Control&Prevention; Population Policies; Health Systems Development&Reform; HIV AIDS;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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