Publication: Payment Incentives for Improved Quality of Health Service Delivery in Republika Srpska and the Federation of Bosnia and Herzegovina
Loading...
Published
2024-01-05
ISSN
Date
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 Disease Control Priorities, Third Edition(Washington, DC: World Bank, 2016-03-21)Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.Publication The Economics of Health Professional Education and Careers(Washington, DC: World Bank, 2015-09-03)The formation of health professionals is critical for the health system to function and achieve its universal health coverage (UHC) goals. This is well recognized by the majority of governments that plan for the training and regulations necessary to ensure quality. But the importance of market forces is often overlooked, resulting in interventions and regulations that often fail to achieve their intended effects. The Economics of Health Professional Education and Careers aims to inform the design of health professionals’ education policies to better manage health labor market forces toward UHC. It documents what is known about the influence of market forces on the health professional formation process. The contexts of the market for health professional training have been subject to important changes in recent decades, in particular: the growing extent of employment of mid-level cadres of health professionals; changes in technology and the associated growth of high-skilled occupations; the increasing interconnectedness of national health systems through globalization, with its implications for international health professional mobility; and the greater complexity of the public-private mix in employment options. There is a need to ensure that market forces align with the intentions of planning and regulation and the UHC goals. This study provides recommendations to support the design of policies that help to achieve these goals.Publication World Development Report 1993(New York: Oxford University Press, 1993)This is the sixteenth in the annual series and examines the interplay between human health, health policy and economic development. Because good health increases the economic productivity of individuals and the economic growth rate of countries, investing in health is one means of accelerating development. More important, good health is a goal in itself. During the past forty years life expectancy in the developing world has risen and child mortality has decreased, sometimes dramatically. But progress is only one side of the picture. The toll from childhood and tropical diseases remains high even as new problems - including AIDS and the diseases of aging populations - appear on the scene. And all countries are struggling with the problems of controlling health expenditures and making health care accessible to the broad population. This report examines the controversial questions surrounding health care and health policy. Its findings are based in large part on innovative research, including estimation of the global burden of disease and the cost-effectiveness of interventions. These assessments can help in setting priorities for health spending. The report advocates a threefold approach to health policy for governments in developing countries and in the formerly socialist countries. First, to foster an economic environment that will enable households to improve their own health. Policies for economic growth that ensure income gains for the poor are essential. So, too, is expanded investment in schooling, particulary for girls. Second, redirect government spending away from specialized care and toward such low-cost and highly effective activities such as immunization, programs to combat micronutrient deficiencies, and control and treatment of infectious diseases. By adopting the packages of public health measures and essential clinical care dsecribed in the report, developing countries could reduce their burden of disease by 25 percent. Third, encourage greater diversity and competition in the provision of health services by decentralizing government services, promoting competitive procurement practices, fostering greater involvement by nongovernmental and other private organizations, and regulating insurance markets. These reforms could translate into longer, healthier, and more productive lives for people around the world, and especially for the more than 1 billion poor. As in previous editions, this report includes the World Development Indicators, which give comprehensive, current data on social and economic development in more than 200 countries and territories.Publication Shock Waves(Washington, DC: World Bank, 2016)Ending poverty and stabilizing climate change will be two unprecedented global achievements and two major steps toward sustainable development. But the two objectives cannot be considered in isolation: they need to be jointly tackled through an integrated strategy. This report brings together those two objectives and explores how they can more easily be achieved if considered together. It examines the potential impact of climate change and climate policies on poverty reduction. It also provides guidance on how to create a “win-win” situation so that climate change policies contribute to poverty reduction and poverty-reduction policies contribute to climate change mitigation and resilience building. The key finding of the report is that climate change represents a significant obstacle to the sustained eradication of poverty, but future impacts on poverty are determined by policy choices: rapid, inclusive, and climate-informed development can prevent most short-term impacts whereas immediate pro-poor, emissions-reduction policies can drastically limit long-term ones.Publication Human Resources for Mental Health Service Delivery in Viet Nam(Washington, DC: World Bank, 2024-05-30)"Human Resources for Mental Health Service Delivery in Viet Nam" provides an overview of the country’s current state of and challenges to mental health service delivery. The framework of the report is composed of four interconnected domains: health care, social services, education and mental health literacy, and informal care systems. The organizational structure, significant achievements, critical gaps, and problems in mental health service delivery at the institutional and community levels are highlighted in terms of public demand, availability, accessibility, and quality of service. The report uses new empirical data from surveys, workshops, and group discussions with key stakeholders. It describes the mental health workforce in Viet Nam and analyzes critical issues, including the shortage of professionals (psychiatrists, mental health nurses, psychologists, psychotherapists, social workers, occupational therapists, and others). Given the need to develop all levels of mental health care, the report addresses the uneven distribution of the provision of service between levels of health care institutions and rural and urban regions, competency mismatches, job satisfaction, recruitment, and challenges to the retention of mental health workers. The report also examines the need for mental health education and training at the institutional and structured program levels, as well as the supply constraints to the future development of the mental health workforce. The interdisciplinary team of authors emphasizes the urgent need for Viet Nam to strengthen its human resources for mental health service delivery toward achieving universal health coverage, including all mental disorders. The report’s evidence-based recommendations include multisectoral workforce planning; transformation of education and training; coordination, integration, and retention of the available workforce; improvement of the workforce governance framework; and strengthened mental health financing.