Using performance incentives.

When the goal is to reduce needless death and disease and part of what is getting in the way is a misalignment between health goals and the real-world behaviors of individual patients health workers and those who influence them it may be time to consider performance incentives. These can complement other interventions such as providing training revamping infrastructure and improving the supply of drugs and other inputs. Here we look at how performance incentives can contribute to better health results increased use of services enhanced quality and improved efficiency. To identify the experiences to highlight in this book we searched the published literature consulted experts and included regional and national cases with substantial documented evidence. The evidence discussed here and in the case summaries in part 2 relies on both evaluations conducted with varying degrees of rigor and other sources of information. It comes from qualitative surveys baseline and endline statistics contrasts between intervention and comparison groups and routine program monitoring. (Excerpt)