Impact of performance-based financing on health-care quality and utilization in urban areas of Cameroon

ABSTRACT

This article looks at a pilot project designed to estimate the impact of performance-based financing (PBF) on the quality and utilization of health care in a predominantly urban setting - the Littoral region of Cameroon. It uses three quasi-experimental impact evaluation methods involving matching and difference-in-difference. Results show that the PBF pilot had a positive and significant impact on most essential aspects of quality of care. Meanwhile; there was no impact on any of the indicators of health service utilization with the exception (limited) of modern contraceptive methods. These findings suggest that the setting and indicators chosen are important in achieving maximum impact. However; it should also be noted that improvements in utilization might be limited as a result of high baseline figures. Finally; the findings show that the quality of care seems to be the most promising aspect in terms of improvements related to PBF in urban settings