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An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and quality of care. These projects contributed toward increasing institutional delivery, requiring less incentive cost compared to that of the DSF program, and enhancing client satisfaction by reducing out-of-pocket expenses. Despite the brief implementation period, contribution of P4P interventions in rapidly raising the level of institutional deliveries creates optimism toward meeting the MDG of reducing maternal and infant mortality.





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