Supply-side pay for performance (P4P), consisting of quarterly payments to health facilities, will be piloted in Bénin as of mid 2010 with the goal of increasing utilization of maternal health care services and improving maternal health outcomes. This scheme also seeks to test the hypothesis that P4P may have a stronger impact if health facility managers have more autonomy. Interesting features of this program include the fact that payments are being set up to motivate collective group behavior rather than individual behavior and that facilities must use at least 50 percent of the financial reward for the purchase of inputs, such as equipment (including ambulances) or drugs, and/or services such as training programs or information, education, communication efforts. This case study provides a snapshot of public sector piloting of P4P and offers lessons on start-up and buy-in for countries that are considering implementing similar government-led nationwide schemes.
(Available on the Health Systems 20/20 <http://www.healthsystems2020.org/content/resource/detail/2619/> website)