The Unassuming Economist

In a column for VoxDev ( December 2021), economists Eeshani Kandpal and Elina Pradhan of the World Bank Development Research Group, Madhulika Khanna from Yale University, and Benjamin Loevinsohn of The Global Fund explain results from an experiment in Nigeria. “Providing operating funds to public health facilities can be as effective as alternative pay-for-performance models, at half the cost”, they write.

The authors discuss some factors besides poor effort put in by healthcare workers, such as lack of control on operational budget by PHCs which causes delays and other inefficiencies to build a case in favor of decentralized financing. The study compares outcomes from two interventions- pay for performance and decentralized facility financing. It presents conclusions about the performance of both interventions in areas like quality of service delivered, immunization of children, use of contraceptives, antenatal care-seeking. The article also discusses several policy insights.

Click here to read the full column.