RESUMO
Results-based financing (RBF) is an innovative approach to health system financing which pays providers for verified outputs. In July 2011; through a World Bank grant; Zimbabwe commenced an RBF project to improve utilization of quality maternal; neonatal and child health (MNCH) services. This article discusses its early results. A statistical analysis of intervention districts and control districts shows that RBF districts demonstrate higher increases in utilization levels for the MNCH services than control districts. Month-on-month growth rates for antenatal care; perinatal referrals and growth monitoring are statistically significant after the intervention; whilst they were not before the intervention and no significant trend was found in control districts. Qualitative study provides insight in the mechanisms through which RBF contributed to better performance: the use of contracts; increased autonomy of health facilities; increased community involvement; intrinsic motivation of health-care workers; existence of a reliable health information system; abolishment of user fees; improved supervision of health facilities; separation of functions; and the Government of Zimbabwe's results-based management (RBM) policy