Performance-Based Financing Improves Quantity and Quality of Health Services in Haiti


Performance-based financing (PBF) has been used increasingly to improve the quantity and quality of health services by directly rewarding providers with financial incentives based on achieved results.

By aligning the interests and goals of the purchaser and health care providers, PBF has been shown to increase the efficiency of service provision while addressing common challenges among health care providers, including low motivation, attrition, insufficient empowerment, and a lack of accountability for results.

Since 1999, Haiti's Ministry of Public Health and Population (MSPP) has used PBF to improve the availability, accessibility, and quality of primary health services. Recognizing the success of this approach, in 2012, the MSPP officially adopted PBF in its National Health Policy's health sector financing strategy. To ensure coordination and reduce potential conflicts of interest, Haiti's PBF policy has separated the key stakeholder functions of the program. For example, separate entities within the MSPP carry out the work of program financiers, regulators, and purchasers while an external verification agency ensures the accuracy of all results reported by health facilities.