Using provider performance incentives to increase HIV testing and counseling services in Rwanda
Journal of Health Economics
Development Research Group, The World Bank, United States; Haas School of Business, University of California, Berkeley, United States; National Institute of Public Health, Cuernavaca, Mexico; The World Bank, United States; Camris International, United States; Ministry of Health, Government of Rwanda, Kigali, Rwanda; Harvard Medical School, Department of Global Health and Social Medicine, United States; Geisel School of Medicine, Dartmouth College, United States; School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. © 2014 Published by Elsevier B.V.
acquired immune deficiency syndrome; health services; human immunodeficiency virus; incentive; acquired immune deficiency syndrome; adolescent; adult; Article; controlled study; female; health care delivery; health care planning; health care quality; HIV test; human; Human immunodeficiency virus infection; male; marital therapy; pay for performance; personnel management; prospective study; quasi experimental study; Rwanda; total quality management; Rwanda