Impact of a Service Provider Incentive Payment Scheme on Quality of Reproductive and Child-health Services in Egypt

Abstract

A case-control, quasi-experimental study was designed (post-test only) to investigate the effect of a performance-
based incentive payment scheme on behaviours of public-sector service providers in delivering
a basic package of maternal and child-health services in Egyptian primary healthcare units. The results
showed significant improvements in the quality of family-planning, antenatal care, and child-care services
as reported by women seen in clinics where the incentive payment scheme was in operation as measured
by various indicators, including both technical and inter-personal communication content. An analysis of
characteristics of the service providers and clients found no significant or meaningful differences between
the study groups, and the facilities of both the study groups were essentially the same. Some findings are
suggestive of other influences on behaviours of the service providers not captured by the data-collection
instruments of the study. Subsequent to this study, the payment scheme has been rolled out to other districts
in Egypt.

Key words: Performance payments; Child Health; Reproductive health; Impact studies; Quality of care;
Case-control studies; Health services; Egypt

DOI: 10.3329/jhpn.v28i3.5556

J HEALTH POPUL NUTR 2010 Jun;28(3):273-280