Effects of Performance‐Based Financing on Availability, Quality, and Use of Family Planning Services in the Democratic Republic of Congo
An Impact Evaluation
Bibliographic Data
| ID | 10797228 |
|---|---|
| Authors | Salomé Henriette Paulette Drouard (0000-0002-1520-8088), Stephan Brenner (0000-0001-5397-7008), Delphin Antwisi, Ndeye Khady Toure, Supriya Madhavan, Günther Fink (0000-0001-7525-3668), Gilad Shapira (0000-0002-1138-7269, Medical Protective, corresponding author) |
| Year | 2024 |
| Volume | 55 |
| Issue | 2 |
| Pages | 127-149 |
| Publication date | 2024-06-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Studies in Family Planning (JOURNAL) |
| Journal identifiers | ISSN: 0039-3665 • E-ISSN: 1728-4465 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/sifp.12264 |
| PMID | 38627906 |
| OpenAlex | W4394873617 |
| Language | EN |
| Citations received | 1 |
| References cited | 38 |
Access to high‐quality family planning services remains limited in many low‐ and middle‐income countries, resulting in a high burden of unintended pregnancies and adverse health outcomes. We used data from a large randomized controlled trial in the Democratic Republic of Congo to test whether performance‐based financing (PBF) can increase the availability, quality, and use of family planning services. Starting at the end of 2016, 30 health zones were randomly assigned to a PBF program, in which health facilities received financing conditional on the quantity and quality of offered services. Twenty‐eight health zones were assigned to a control group in which health facilities received unconditional financing of a similar magnitude. Follow‐up data collection took place in 2021–2022 and included 346 health facility assessments, 476 direct clinical observations of family planning consultations, and 9,585 household surveys. Findings from multivariable regression models show that the PBF program had strong positive impacts on the availability and quality of family planning services. Specifically, the program increased the likelihood that health facilities offered any family planning services by 20 percentage points and increased the likelihood that health facilities had contraceptive pills, injectables, and implants available by 23, 24, and 20 percentage points, respectively. The program also improved the process quality of family planning consultations by 0.59 standard deviations. Despite these improvements, and in addition to reductions in service fees, the program had a modest impact on contraceptive use, increasing the modern method use among sexually active women of reproductive age by 4 percentage points (equivalent to a 37 percent increase), with no significant impact on adolescent contraceptive use. These results suggest that although PBF can be an effective approach for improving the supply of family planning services, complementary demand‐side interventions are likely needed in a setting with very low baseline utilization
Business · Developing country · Economic growth · Economics · Environmental health · Family planning · Health facility · Health services · Political science · Population · Program evaluation · Quality (philosophy · Reproductive health · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Public Administration
The Quality of Care
Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance
Disruptions in maternal and child health service utilization during Covid-19
Quality of care for children with severe disease in the Democratic Republic of the Congo
Looking into the performance-based financing black box
Paying for Performance to Improve the Delivery and Uptake of Family Planning in Low and Middle Income Countries
Quality of clinical assessment and child mortality
Validation of Two Quality of Care Measures
Revising the FP Quality of Care Framework in the Context of Rights‐based Family Planning
Inequality in the Quality of Health Services
Outpatient process quality evaluation and the Hawthorne Effect
| Citations per year | 1 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |