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APHA Scientific Session and Event Listing

Ben Bellows, MPH, Epidemiology Division, University of California, Berkeley, 140 Warren Hall, Berkeley, CA 94708, 510-643-7627, bbellows@berkeley.edu

While the need for development assistance to improve reproductive health outcomes in developing countries is pressing, the effective allocation of available resources can be difficult. This paper addresses the problem of inefficiency in the current input based approach and discusses the potential for and advantages and disadvantages of output-based assistance. In an output-based assistance approach, a unit cost is calculated and agreed upon for an essential output, and health care providers are paid directly per output completed. The World Bank has called for donor aid to focus more ‘on outcomes and results'. Currently, most development health assistance is given as input-based support where financial support is given in advance to the recipient government or to a non-governmental organization to cover the various costs associated with implementing an agreed programme of work. A pilot begun with the Kenyan National Coordinating Agency for Population and Development (NCAPD) and the German Credit for Development Bank will test output-based aid contracts in the delivery of family planning, antenatal, attended delivery, and postnatal care in private sector clinics serving low-income women. There is a growing interest in output-based funding for reproductive health and a need to understand the advantages and disadvantages of the output-based strategy.

Learning Objectives:

• Describe the general finance structure of output-based and input-based aid in delivery of reproductive health services.
• Evaluate potential for greater equity in reproductive health access under output-based aid.
• Identify the potential program profiles where output-based aid may be applied successfully.
• Describe the limitations of output-based aid.
• Define the implementation characterisics in a Kenya pilot begun in second half of 2006.

Keywords: Access to Health Care, Competition

Related Web page: www.output-based-aid.net/index_eng.html

Presenting author's disclosure statement:

Not Answered