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Some performance incentives aim to improve provider behavior, promoting delivery of more and better services; others focus on household or patient behavior, to increase health service utilization or affect health-related lifestyle choices. How well do they work? The group’s final report, Performance Incentives for Global Health: Potential and Pitfalls, offers recommendations for donors and policymakers in developing countries seeking to broaden the menu of ways to improve health systems. Early working group discussions influenced the World Bank's creation of the Health Results Innovation Trust Fund (HRITF).
The Center for Global Development hosted two side events in Lima during the 20th UNFCCC Conference of Parties. On December 3rd and December 5th, CGD experts Frances Seymour and Jonah Busch presented findings from their forthcoming book, Why Forests? Why Now?, which draws upon science, economics, and political analysis to show that tropical forests are essential for climate stability and sustainable development, that now is the time for action, and that payment-for-performance finance is a course of action with great potential for success. Background paper authors presented highlights from their analyses and discussed how their findings contribute to the mounting evidence of the urgency, affordability, and feasibility of scaled-up funding to reduce the rate of deforestation, particularly through performance-based approaches.
In 2009, Guyana created a Low Carbon Development Strategy to develop economically while keeping its entire forest intact, and signed a Memorandum of Understanding with Norway to receive performance-based payments in the tens of millions of dollars annually contingent upon holding nationwide deforestation to a near-zero rate. In mid-February, 2014, we visited Guyana as part of a three-country study to attempt to gain insights of value to the future expansion of performance-based payments in other countries and other sectors.
Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group
Donor spending on global health has surged, yet for many poor people in developing countries even basic prevention and treatment remain elusive. CGD’s newest book, Performance Incentives for Global Health: Potential and Pitfalls, shows how modest payments in cash or kind can get more health from health care spending. Informed by case studies and the Working Group on Performance-Based Incentives, co-authors Rena Eichler and CGD vice president Ruth Levine tell how to design and implement effective incentive programs—and what to avoid.