Does Dosage Matter? Effects of Results-Based Financing Layered on Top of Less Comprehensive Direct Facility Financing in Tanzania
A new article in Health Policy and Planning examines whether stronger financial incentives can improve healthcare delivery beyond simpler funding reforms.
In “Does Dosage Matter? Effects of Results-Based Financing Layered on Top of Less Comprehensive Direct Facility Financing in Tanzania”, Eskindir Loha, Vincent Somville, Jo Borghi, Peter Binyaruka, and Ottar Mæstad investigate the effects of introducing results-based financing (RBF) on top of an existing direct facility financing programme in Tanzania. Using data from 150 health facilities and more than 3,000 households collected over four years, the authors compare districts that implemented both schemes with districts that implemented only the less comprehensive financing model.
The study finds that adding RBF led to significant improvements in a range of outcomes, including service coverage, quality of care, patient satisfaction, and health worker job satisfaction. The results suggest that additional resources and performance incentives can generate substantial gains in healthcare delivery, even when other financing reforms are already in place.
Taken together, the study provides new evidence on how the design of health financing systems can improve service delivery and health outcomes in low- and middle-income countries.