Performance-based Incentives (PBI), a strategy that links payment to results achieved, is a potentially powerful catalyst to strengthen health systems and achieve health targets. Numerous developing countries, many with USAID support, are piloting and scaling-up PBI programs to improve health outcomes and make progress towards achieving the health Millennium Development Goals.
However, PBI is not a solution for all problems in the health system and is not a substitute for investments in training, health facilities, and infrastructure. Each country context has to be assessed to understand the potential contribution of performance incentives to improving health outcomes.
This primer provides information for USAID Missions on how to support a PBI program, be it through technical assistance (TA) to an existing program or directly funding a pilot or scaled-up national program. The Primer starts with a quick overview of PBI as one solution to strengthen health systems and improve health service delivery and health outcomes. The note also includes summaries of country experiences with PBI as well as sources for further information.