In: BMC Health Services Research, 18 (2018), Nr. 791. pp. 1-10. ISSN 1472-6963
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Abstract
Abstract: Background Results-based financing (RBF) describes health system approaches addressing both service quality and use. Effective coverage is a metric measuring progress towards universal health coverage (UHC). Although considered a means towards achieving UHC in settings with weak health financing modalities, the impact of RBF on effective coverage has not been explicitly studied.
Methods: Malawi introduced the Results-Based Financing For Maternal and Neonatal Health (RBF4MNH) Initiative in 2013 to improve quality of maternal and newborn health services at emergency obstetric care facilities. Using a quasi-experimental design, we examined the impact of the RBF4MNH on both crude and effective coverage of pregnant women across four districts during the two years following implementation.
Results: There was no effect on crude coverage. With a larger proportion of women in intervention areas receiving more effective care over time, the overall net increase in effective coverage was 7.1%-points (p = 0.07). The strongest impact on effective coverage (31.0%-point increase, p = 0.02) occurred only at lower cut-off level (60% of maximum score) of obstetric care effectiveness. Design-specific and wider health system factors likely limited the program’s potential to produce stronger effects.
Conclusion: The RBF4MNH improved effective coverage of pregnant women and seems to be a promising reform approach towards reaching UHC. Given the short study period, the full potential of the current RBF scheme has likely not yet been reached.
Document type: | Article |
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Journal or Publication Title: | BMC Health Services Research |
Volume: | 18 |
Number: | 791 |
Publisher: | BioMed Central |
Place of Publication: | London |
Date Deposited: | 07 Nov 2018 16:29 |
Date: | 2018 |
ISSN: | 1472-6963 |
Page Range: | pp. 1-10 |
Faculties / Institutes: | Medizinische Fakultät Heidelberg > Heidelberg Institute for Global Health (HIGH) |
DDC-classification: | 610 Medical sciences Medicine |