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In Bangladesh, maternal health programs are not yet reaching the desired level of facility-based obstetric care service. Most deliveries are conducted by untrained persons at home, demonstrating inequity in access to recommended maternal health care services and underutilization of existing obstetric and newborn care services. Suboptimal performance by providers is a key barrier to improving availability and quality of maternal, newborn, and child health (MNCH) services. To increase use of facility-based services, an operations research study of “pay-for-performance” (P4P) incentives for providers and subsidization of consumer costs was initiated in 2010. The study, part of the Government of Bangladesh–United Nations MNCH and maternal and newborn health projects, has been included as a human resource innovation project under the operational plan of the Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, Government of Bangladesh. The Population Council provided technical assistance in implementing the study, with collaboration from James P. Grant School of Public Health of BRAC University. This policy brief describes the implementation of the P4P operations research study and its consequent implications for policymakers.






Pay-for-Performance (P4P) to Increase Use of Maternal, Neonatal, and Child Health Services in Bangladesh