Performance-based Incentives in Africa: Taking Stock of Current Programs and Future Potentials

PBI in Africa-BriefLindsay Morgan and Rena Eichler

Performance-based incentive (PBI) programs are in various stages of development in countries across sub-Saharan Africa. Many programs are pilots, but some countries have integrated PBI into their health systems and scaled up programs nationally. Performance incentives offered to teams of health workers, subnational levels of government, contracted nongovernmental organizations (NGOs), or patients, among others, aim to motivate the health workforce, focus attention on (and provide demonstrable evidence of) results; strengthen information systems; build local capacity to manage and deliver health services; and, of course, improve health outcomes. This paper traces the evolution of PBI programs in sub- Saharan Africa and shares evidence on its impact on health and health systems as well as the gaps in knowledge and practice. It is based on a longer report of the same name.

(Available on the Health Systems 20/20 <>  website)