East Africa Public Health Laboratory Networking Project : Evaluation of Performance-Based Financing for Public Health Laboratories in Rwanda
This report summarizes the main findings from the application of performance based incentives linked to progress on a standardized, globally recognized metric - the stepwise laboratory improvement process towards accreditation (SLIPTA) checklist -...
| Main Authors: | , , , , , |
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| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2016
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2016/04/26284094/east-africa-public-health-laboratory-networking-project-evaluation-performance-based-financing-public-health-laboratories-rwanda http://hdl.handle.net/10986/24400 |
| Summary: | This report summarizes the main findings
from the application of performance based incentives linked
to progress on a standardized, globally recognized metric -
the stepwise laboratory improvement process towards
accreditation (SLIPTA) checklist - under the East Africa
Public Health Laboratory Networking Project (EAPHLNP) in
Rwanda. The lab performance-based financing (PBF) pilot was
introduced in the context of a well-established national PBF
program dating back to the early 2000s. The flexible nature
of the EAPHLNP and the favorable context in Rwanda provided
an ideal backdrop to introduce PBF incentive payments to
accelerate progress of five project supported labs towards
accreditation. The evaluation found improved laboratory
performance at all project-supported laboratories in Rwanda
as measured by the SLIPTA scores. For the first time,
laboratories were bringing in PBF revenues, instilling a
culture of continuous quality improvements, and focusing
management attention on accreditation. PBF appears to have
contributed to an accelerated change, with PBF laboratories
experiencing an overall greater increase in SLIPTA scores
compared to project-supported laboratories in the other
countries. No clear patterns were found in terms of improved
test volumes or test accuracy, which were not part of the
pilot scheme. While it was difficult to disentangle the
effects of different interventions, the evaluation found a
system-strengthening value to combining investments in
modernizing laboratories, and strengthening human resources
with PBF. Relationships between laboratory staff and
clinicians improved, with laboratory managers having a
greater voice in hospital management and lab staff
increasingly valued and respected by clinicians. A spirit of
teamwork prevailed at participating sites. Other countries
considering PBF mechanisms for public health laboratories
need to take into account lessons learned and assess the
features which may be relevant to their own contexts. PBF
schemes for laboratories need to be viewed as an integral
part of a package of interventions that contribute to
enhanced performance. |
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