Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114796

Atia Hossain, Pathfinder International, 9 Galen St., Suite 217, Watertown, MA 02466, 617-924-7200, mkane@pathfind.org, Ferdousi Begum, MBBS, MPH, Pathfinder International-Bangladesh Office, 9 Galen Street, Suite 217, Watertown, MA 02472, and Dennis NW Chao, MD, Bangladesh, Pathfinder International, 9 Galen St., Suite 217, Watertown, MA 02472.

Background: Using incentives to motivate providers to care for the very poor has had limited success. NSDP Bangladesh, mandated to improve health care for the poor, is implementing an innovative approach to address this problem. NSDP aims to prove that the government and donor community can meet user fees for those who otherwise could not, relieving NGOs of the financial burden.

Presently, NGOs are not systematically rewarded. Previous efforts to increase both cost-recovery rates and services provided to the very poor yield the unintended consequence that USAID funds subsidize everyone—including the rich—except the poor. A good incentive scheme must both address these problems and motivate NGO providers to serve the poor.

Under the scheme each NGO must set cost recovery targets. Then bonuses, distributed from a Health Equity Fund, will reward both NGOs and providers according to performance measured by both services for the poor and cost recovery rate. The incentive plan has been initially implemented in four NGOs. Four additional NGOs will function as controls.

Results: The sample NGOs should serve more very poor customers (5% of the total) compared with 1.25% for the control NGOs. Cost recovery increases should range from 1.5% to 10% compared with 2.50% for the control NGOs. The four NGOs' bonuses will range from $2,491 to $16,606.

Program-specific performance indicators will measure the initiative's impact.

Learning Objectives:

• Participants will be able to evaluate an innovative scheme to improve non-profit health services for poor clients in Bangladesh.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation