Incentivizing Quality of Delivery (IQD)

Village health team members in Kumi, Uganda discuss how to improve family planning data collection.

© 2017 Laura Wando, Courtesy of Photoshare

Many low- and middle-income countries are working to incentivize the quality of delivery of health services and commodities, including through performance-based financing (PBF) strategies and public health supply chain (PHSC) system reforms. PBF strategies, which incentivize providers based on their achievement of agreed-upon, measurable performance targets, are increasingly applied to achieve aims related to health services, health outcomes, and cost containment. These strategies generally focus on addressing poor utilization of critical services like antenatal and postnatal care and facility-based delivery, as well as quality of care (QoC) measures. Strengthening PHSC systems to improve availability of essential health commodities at the point of service is essential for the provision of high quality care. We will explore actionable steps to this strengthening, including potential links between optimizing PBF and PHSC.

The Implementation Science Collaborative will build on USAID’s Translating Research into Action (TRAction) Project-supported PBF research that sought both to contribute to the evidence on whether and how PBF interventions increased the quality of maternal, neonatal, and child health (MNCH) services, and to examine how best to integrate quality measures in PBF programs. Leveraging USAID’s investments in operations research for PHSC systems in relation to reproductive health and family planning commodities, we will explore a learning agenda on supply chain strengthening to improve commodity access down to the ‘last mile’. We will seek to elaborate the next generation of implementation questions in this area, from giving PBF programs and PHSC systems better evidence and guidance on quality and performance measurement, to linking these areas with ongoing quality improvement and scale-up of priority high-impact practices, and on to addressing context-specific implementation challenges, including at the community-level and in urban settings. Stakeholders will be engaged to contribute to development of learning agendas in each of these sub-areas (PBF and PHSC), identify evidence liberation priorities, and prepare for requests for applications to address evidence gaps in incentivizing quality of delivery.