Publication: Payment Incentives for Improved Quality of Health Service Delivery in Republika Srpska and the Federation of Bosnia and Herzegovina
Loading...
Date
2024-01-05
ISSN
Published
2024-01-05
Author(s)
Editor(s)
Abstract
This report outlines a strategic approach to introduce pay-for-performance (P4P) incentives for improved noncommunicable disease (NCD) care in Republika Srpska (RS) and the Federation of Bosnia and Herzegovina (FBiH). Developed under the context of the Functional Review of Health Systems’ Performance Program financed by the European Union and implemented by the World Bank Group, it intends to provide initial framework for methodological documents to be supported by the Health Systems Improvement Project (HSIP), focusing on evidence-based, technically sound, and politically feasible strategies. Participatorily developed, the report synthesizes global lessons and analyzes the policy environment in RS and FBiH. It proposes key design features, addressing strategic opportunities and operational challenges. Behavioral economics insights and political economy factors inform the approach, identifying key levers, opportunities, and challenges affecting P4P implementation capacity. To enhance NCD care quality, the report recommends changes in the provider payment mix, tailored reforms at entity and cantonal levels, and active service user engagement. Emphasizing the importance of linking payment incentives to performance, the proposed design spans dimensions such as performance measures, basis of payment, payment attributes, recipient of payment, and targeted outcomes. An enabling environment is deemed critical. Relatedly, effective implementation requires robust data systems, stakeholder engagement, adapted legal frameworks, and suitable institutional arrangements. Technical assistance and budgetary support needs are identified. It is expected that P4P implementation will enhance NCD care coverage and quality, thereby improving health outcomes and overall health system performance in RS and FBiH.
Link to Data Set
Citation
“Huseinagic, Senad; Stevic, Sinisa; Birungi, Charles; Chukwuma, Adanna. 2024. Payment Incentives for Improved Quality of Health Service Delivery in Republika Srpska and the Federation of Bosnia and Herzegovina. © World Bank. http://hdl.handle.net/10986/40849 License: CC BY-NC 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Related items
Showing items related by metadata.
Publication Achieving the Millennium Development Goal of Improving Maternal Health : Determinants, Interventions and Challenges(World Bank, Washington, DC, 2005-03)This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. The paper finds that key interventions to improve maternal and reproductive health and reduce maternal mortality include the following mutually reinforcing strategies: (a) mobilizing political commitment and fostering an enabling policy environment; (b) investing in social and economic development such as female education, poverty reduction, and improvements in women's status; (c) providing family planning services; (d) ensuring quality antenatal care, skilled attendance during childbirth, and availability of emergency obstetric services for pregnancy complications; and (e) strengthening the health system and community involvement. The paper emphasizes that carrying out interventions remains a challenge in environments where political commitment, policies, as well as institutions and health systems, are weak. The paper concludes with guiding lessons from some of the countries that have successfully improved maternal health and with a discussion of some of the difficulties of measuring maternal mortality and morbidity outcomes.Publication Challenges and Opportunities for Purchasing High-Quality Health Care(Taylor and Francis, 2021-04-29)This paper examines how purchasing decisions in Armenia may contribute to barriers in using high-quality health care, particularly for non-communicable diseases, drawing on a review of the literature and key informant interviews. The paper adapts the strategic health purchasing progress framework, to examine how characteristics of purchasing, the health system, and the political, administrative, and macro-fiscal environment may have facilitated or hindered the attainment of service delivery goals. We conclude with six lessons for reforms aimed at improving the coverage and quality of health care in Armenia. First, increasing the political priority of access to quality of health care is a pre-requisite to advancing reforms to address these issues. Second, improved purchasing governance in Armenia will require a purchaser that can make decisions without political interference, with appropriate accountability mechanisms, improvements in technical capacity, and the routine use of data systems. Third, there is a need for the regulatory framework to ensure that revisions of the benefits package contribute to reducing the disease burden and improving access to care. Fourth, regulations governing quality-related criteria for provider selection should be enforced and include considerations for process quality. Fifth, payment incentives should be revised to encourage an increase in the supply of primary health care, reduce bypassing for hospital care, and improve the quality of services. Sixth, the potential of purchasing to improve service delivery will be dependent on increased pre-paid and pooled funds and better governance of the quality of care.Publication Republic of Congo : Enhancing Efficiency in Education and Health Public Spending for Improved Quality Service Delivery for All(Washington, DC, 2014-06)The development of a wealthier, literate, and healthy society is a fundamental goal of Congo's national development plan (NDP) 2012-16 and poverty reduction strategy paper (PRSP) 2012-16. Appropriate funding allocations and efficient use of funds in education and health are fundamental for the development of the sectors. This public expenditure review (PER) of the Congolese education and health sectors aims at providing inputs to improve efficiency and equity in spending in these sectors. It takes into account the following findings of the macro PER: (i) spending on the social sectors is still low although it has increased over time; (ii) the fiscal space generated by the increased oil revenues has largely boosted investment expenditure; and (iii) budget execution is low which contributes to lower the real level of public spending. The PER is divided in two main parts. Part I, constitutes an overview of the two sector reports. Thus, it presents a brief analysis of the context of the country, a summary of findings of the education and health PER, a discussion on cross-cutting themes on spending in the two sectors, and a summary of recommendations. Part II includes the education and health PER.Publication Bosnia and Herzegovina : Accounting and Auditing(Washington, DC, 2010-12)This assessment of accounting and auditing (A&A) practices in Bosnia and Herzegovina is part of a joint initiative by the World Bank and International Monetary Fund (IMF) to prepare reports on the Observance of Standards and Codes (ROSC). The assessment focuses on the strengths and weaknesses of the accounting and auditing environment that influence the quality of corporate financial reporting, and includes a review of both statutory requirements and actual practice. It uses International Financial Reporting Standards (IFRS) and International Standards on Auditing (ISA) as benchmarks and draws on international experience and best practices. This assessment updates the findings of the previous A&A ROSC conducted and published in Bosnia and Herzegovina in 2004. With a population of 3.8 million, Bosnia and Herzegovina is one of the smallest countries in Central and Eastern Europe. That population is largely made up of three constituent peoples: Bosniaks, Serbs, and Croats. Prior to the war, the three groups were more evenly distributed throughout the territory of Bosnia and Herzegovina, but now FBH's population is predominantly Bosniaks and Croats, while the RS has mostly Serbs. Since the war, Bosnia and Herzegovina has seen great progress in post-conflict reconstruction and development as well as in terms of reintegration and reconciliation. In recent years, Bosnia and Herzegovina has seen robust economic growth. After the war, this was initially driven by reconstruction efforts, but later private sector investment contributed to most of the growth. Between 2004 and 2008, the economy of Bosnia and Herzegovina grew at an average annual rate of 6 percent in real terms, and gross domestic product (GDP) growth peaked in 2007 at around 7 percent. Although economic activity started to weaken with the onset of the financial crisis, GDP growth was still relatively strong in 2008 at 5.4 percent. Both private investment and consumption saw strong growth, and export growth averaged 25 percent per annum over the period. Inflation was moderate during this period, amounting to just 3.8 percent in 2008 (year-on-year), despite a sharp rise in fuel and food prices in the first half of the year. The level of external public debt has been relatively low, but has been growing with the onset of the global crisis. In this context, this A&A ROSC aims to support the strategic objective of furthering the development of Bosnia and Herzegovina's corporate sector, improving access to finance for domestic enterprises, and reducing the cost of doing business in the country.Publication Disrupted Service Delivery? The Impact of Conflict on Antenatal Care Quality in Kenya(Frontiers Media, 2021-02-28)African countries facing conflict have higher levels of maternal mortality. Understanding the gaps in the utilization of high-quality maternal health care is essential to improving maternal survival in these states. Few studies have estimated the impact of conflict on the quality of health care. In this study, we estimated the impact of conflict on the quality of health care in Kenya, a country with multiple overlapping conflicts and significant disparities in maternal survival. Our study demonstrates the importance of designing maternal health policy based on the context-specific evidence on the mechanisms through which conflict affects health care. In Kenya, deterioration of equipment and infrastructure does not appear to be the main mechanism through which conflict has affected ANC quality. Further research should focus on better understanding the determinants of the gaps in process quality in conflict-affected settings, including provider motivation, competence, and incentives.
Users also downloaded
Showing related downloaded files
Publication Economic Recovery(World Bank, Washington, DC, 2021-04-06)World Bank Group President David Malpass spoke about the world facing major challenges, including COVID, climate change, rising poverty and inequality and growing fragility and violence in many countries. He highlighted vaccines, working closely with Gavi, WHO, and UNICEF, the World Bank has conducted over one hundred capacity assessments, many even more before vaccines were available. The World Bank Group worked to achieve a debt service suspension initiative and increased transparency in debt contracts at developing countries. The World Bank Group is finalizing a new climate change action plan, which includes a big step up in financing, building on their record climate financing over the past two years. He noted big challenges to bring all together to achieve GRID: green, resilient, and inclusive development. Janet Yellen, U.S. Secretary of the Treasury, mentioned focusing on vulnerable people during the pandemic. Kristalina Georgieva, Managing Director of the International Monetary Fund, focused on giving everyone a fair shot during a sustainable recovery. All three commented on the importance of tackling climate change.Publication Education, Social Norms, and the Marriage Penalty(Washington, DC: World Bank, 2024-10-16)A growing literature attributes gender inequality in labor market outcomes in part to the reduction in female labor supply after childbirth, the child penalty. However, if social norms constrain married women’s activities outside the home, then marriage can independently reduce employment, even in the absence childbearing. Given the correlation in timing between childbirth and marriage, conventional estimates of child penalties will conflate these two effects. The paper studies the marriage penalty in South Asia, a context featuring conservative gender norms and low female labor force participation. The study introduces a split-sample, pseudo-panel approach that allows for the separation of marriage and child penalties even in the absence of individual-level panel data. Marriage reduces women’s labor force participation in South Asia by 12 percentage points, whereas the marginal penalty of childbearing is small. Consistent with the central roles of both opportunity costs and social norms, the marriage penalty is smaller among cohorts with higher education and less conservative gender attitudes.Publication Remarks at the United Nations Biodiversity Conference(World Bank, Washington, DC, 2021-10-12)World Bank Group President David Malpass discussed biodiversity and climate change being closely interlinked, with terrestrial and marine ecosystems serving as critically important carbon sinks. At the same time climate change acts as a direct driver of biodiversity and ecosystem services loss. The World Bank has financed biodiversity conservation around the world, including over 116 million hectares of Marine and Coastal Protected Areas, 10 million hectares of Terrestrial Protected Areas, and over 300 protected habitats, biological buffer zones and reserves. The COVID pandemic, biodiversity loss, climate change are all reminders of how connected we are. The recovery from this pandemic is an opportunity to put in place more effective policies, institutions, and resources to address biodiversity loss.Publication Media and Messages for Nutrition and Health(World Bank, Washington, DC, 2020-06)The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition–related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition.Publication Global Regulations, Institutional Development, and Market Authorities Perspective Toolkit (GRIDMAP) - Framework and Methodology(Washington, DC: World Bank, 2024-12-05)GRIDMAP--the Global Regulations, Institutional Development, and Market Authorities Perspective Toolkit--provides emerging markets and developing economies (EMDEs) with a “Minimum Package” of policies to build markets that are trustworthy, safe, and competitive. The “Minimum Package” sets out essential regulatory provisions, institutional arrangements, and implementation and enforcement needed for those markets to thrive. GRIDMAP will provide modules focused on various subjects of market regulation, such as consumer protection and data markets.