Impact of Performance Based Financing in Haiti on Health Outcomes of Women and Children

There is growing recognition that more needs to be done to accelerate progress towards health and development goals. New financing approaches, including performance based financing (PBF), have been implemented in an attempt to more effectively drive health care provision and policy. PBF is the use of money or material goods to affect the actions of those who deliver and/or demand health services. In Haiti, MSH has managed USAID-funded PBF programs since 1999. Through 28 NGOs, access to basic health services is provided to half of Haiti's population under the Santé et Développement pour Stabilité en Haïti (SDSH) project. Many descriptions of how PBF programs are designed and implemented exist, but relatively few studies that link the PBF approach to improved health delivery, outcomes, and impact – this study works to ascertain the health impact of PBF in Haiti by using a pre-post with control design focusing on medical facilities operated by NGO facilities, with the public sector serving as control sites. Qualitative data will be collected to better understand why PBF has worked in Haiti. At this time, only preliminary results are available, but at the time of conference final results will be reported. Preliminary results indicate that PBF has improved health outcomes in women and children, including immunization coverage rates, correct use of ORT, prenatal visits, and availability of modern contraceptive methods. The results of this rigorous study could help drive wider acceptance of PBF and answer some of the questions surrounding whether or not it works.