Columbia International Affairs Online: Policy Briefs

CIAO DATE: 05/2010

Performance Incentives for Global Health: Potential and Pitfalls

Rena Eichler, Ruth Levine

May 2009

Center for Global Development


Global health donors, like national governments, have traditionally paid for inputs such as doctors' salaries or medical equipment in the hope that they would lead to better health. Performance incentives offered to health workers, facility managers, or patients turn the equation on its head: they start with the performance targets and let those most directly affected decide how to achieve them. Funders pay (in money or in kind) when health providers or patients reach specified goals. Evidence shows that such incentives can work in a variety of settings. But making them effective requires careful planning, implementation, and monitoring and evaluation.