TY  - JOUR
TI  - Impact of results-based financing on effective obstetric care coverage: evidence from a quasi-experimental study in Malawi
PB  - BioMed Central
CY  - London
UR  - https://archiv.ub.uni-heidelberg.de/volltextserver/25498/
AV  - public
N2  - 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.
JF  - BMC Health Services Research
A1  - Brenner, Stephan
A1  - Mazalale, Jacob
A1  - Wilhelm, Danielle
A1  - Nesbitt, Robin C.
A1  - Lohela, Terhi J.
A1  - Chinkhumba, Jobiba
A1  - Lohmann, Julia
A1  - Muula, Adamson S.
A1  - De Allegri, Manuela
EP  - 10
SN  - 1472-6963
Y1  - 2018///
IS  - 791
VL  - 18
SP  - 1
ID  - heidok25498
ER  -