Towards a More Balanced Rethinking of Performance-Based Financing.

In a recently published paper in BMJ Global Health, a group of authors (Paul et al) challenged overly optimistic views on performance-based financing (PBF) in the health sector, and its implementation in low- and middle-income countries. While some of the issues they raised are legitimate, the paper paints an overall picture of PBF that does little justice to the reality. This article identifies some features of successful PBF programmes – full-fledged application of PBF, true local ownership, meaningful equity measures, strategic purchasing of indicators and an institutional set-up that anticipates later integration into the national health financing strategy.

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Maarten Oranje
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