Performance-based Incentives for Maternal Health: Taking Stock of Current Programs and Future Potentials

PBI and MHLindsay Morgan, Alix Beith, and Rena Eichler

A woman dies from complications in childbirth every minute – about 529,000 women each year, the vast majority of whom live in developing countries. In sub-Saharan Africa, women have a 1 in 16 chance of dying in pregnancy or childbirth, compared to a 1 in 4,000 risk in developing countries – the largest difference between poor and rich countries of any health indicator (UNICEF n.d.). This has spurred momentum around Millennium Development Goal (MDG) 5, which calls on countries to reduce by three-fourths the maternal mortality ratio and achieve universal access to reproductive health services between 1990 and 2015. This Health System 20/20 report is one in a series exploring cross-cutting themes in PBI, including how maternal and child health improvements are incentivized, and the experience of PBI in sub-Saharan Africa. It is intended to help countries and donors engaged in PBI to fine-tune their programs and to help those thinking of adopting such programs as part of their efforts to strengthen their health system and improve health outcomes.

After a global snapshot of maternal health, we describe the many types of PBI mechanisms being used to improve maternal health, followed by a look at what we know about their impact. We close with a discussion of some of the gaps and ideas for how these models might be strengthened.

(Available on the Health Systems 20/20 <http://www.healthsystems2020.org/files/82490_file_P4P_MH_report_FIN.pdf>  website)