Can performance-based incentive (PBI) programs – programs that reward the delivery of outputs and outcomes with financial incentives – stimulate quality family planning (FP) service provision and enable women to access FP services? Or is incentivizing FP too riddled with risk, too liable to encourage providers to coerce patients or to cause patients to feel pressured to accept an FP method?
This paper discusses what are the best ways for rewarding quality FP counseling and service provision in PBI, and shows how three countries – Burundi, Kenya and Liberia – are doing it. It covers the best types of indicators to link to incentives; approaches for supporting overall quality improvement, including FP; and ensuring high-quality counseling, whether in facilities or in communities where women live.
Though there is a risk that poorly designed PBI programs could lead to distortions and damage informed choice, this paper shows that well-designed PBI programs can have the opposite affect: they can improve the quality of FP service provision, respect patient choice, and empower women and their families.