250372 Impact of Performance Based Financing in Haiti on Health Outcomes of Women and Children

Monday, October 31, 2011: 1:42 PM

Katherine Dilley, MPH , Center for Health Services, Management Sciences for Health, Cambridge, MA
Uder Antoine , Santé et Développement pour Stabilité en Haïti (SDSH), Management Sciences for Health, Cambridge, MA
Bernateau Desmangles , Santé et Développement pour Stabilité en Haïti (SDSH), Management Sciences for Health, Cambridge, MA
Donald S. Shepard, PhD , Schneider Institute for Health Policy, Brandeis University, Waltham, MA
Wu Zeng, MD, MPH , Schneider Institute for Health Policy, Brandeis University, the Heller School for Social Policy and Management, Waltham, MA
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.

Learning Areas:
Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Describe the PBF experience in Haiti. 2. Compare performance based approaches from traditional financing approaches. 2. Explain how and why PBF has worked to improve health outcomes in women and children in Haiti. 4. Describe the impact that PBF has had on the health system in Haiti, and how lessons learned can be applied to other situations to improve health outcomes.

Keywords: Financing, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work for MSH on our performance based financing projects and have been an active contributor on this impact evaluation. I participated in the collection of and analysis of the qualitative data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.