Tajikistan - Feasibility Study for Results-Based Financing (RBF) In the Health Sector

World Bank

dc.creator	World Bank
dc.date	2012-03-19T10:22:18Z
dc.date	2012-03-19T10:22:18Z
dc.date	2010-03-31
dc.date.accessioned	2023-02-17T20:42:36Z
dc.date.available	2023-02-17T20:42:36Z
dc.identifier	http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000333038_20100401003318
dc.identifier	http://hdl.handle.net/10986/2838
dc.identifier.uri	http://localhost:8080/xmlui/handle/CUHPOERS/243199
dc.description	The purpose of this study is to examine the feasibility of introducing Results-Based Financing (RBF) in Tajikistan's health sector. Several countries have experience with RBF in low-income settings, and lessons learned can be interesting for Tajikistan. Technically, RBF is a retrospective provider payment that can be designed to reimburse providers for contractually defined services and specific compliance targets, including for efficiency and quality targets. In Tajikistan RBF will be linked to ongoing provider payment reforms. Therefore, the chapter also provides a brief overview on provider payment mechanisms and experience with provider payment reforms and treatment patterns from middle- and higher-income countries. The objective of this feasibility study is to propose a sustainable RBF pilot program for two oblasts (Khatlon and Sughd), to cost-effectively improve maternal and child health (MCH) outcomes. The study aims to inform the health sector strategy and help the Government and partners to effectively design and use RBF mechanisms at three potential levels. First, the fiscal transfer from the central government to oblasts (regions) and rayons (districts) could be adjusted to include a bonus payment based on specific results achieved. Second, the provider payment method from oblast health fund pools to hospitals and outpatient facilities could reward providers based on results indicators. Third, a performance payment could be added to salaries paid to staff working in health facilities. It is expected that such a three-pronged approach could reinforce the financial incentive set through RBF to staff working in the administration and provision of care. If the staff responds to these incentives, then this could lead to better management in oblast and rayons, improved availability of financial resources and medical material in health facilities, and better treatment of patients. Combined, these behavioral changes will ultimately lead to better health results, including improved quality of care and in the longer-run improved health status.
dc.language	English
dc.publisher	World Bank
dc.rights	CC BY 3.0 IGO
dc.rights	http://creativecommons.org/licenses/by/3.0/igo/
dc.rights	World Bank
dc.subject	ADMINISTRATIVE COSTS
dc.subject	ANTENATAL CARE
dc.subject	APPROPRIATE INCENTIVES
dc.subject	AVAILABILITY OF DRUGS
dc.subject	BASIC HEALTH SERVICES
dc.subject	BEDS
dc.subject	BEHAVIOR CHANGE
dc.subject	BLOCK GRANTS
dc.subject	BUDGET CEILING
dc.subject	BUDGET INCREASE
dc.subject	CAPITATION
dc.subject	CAPITATION PAYMENT
dc.subject	CAPITATION PAYMENTS
dc.subject	CAPITATION SYSTEM
dc.subject	CARE PERFORMANCE
dc.subject	CENTRAL BUDGET
dc.subject	CHILD CARE
dc.subject	CHILD HEALTH
dc.subject	CHILD HEALTH CARE
dc.subject	CHILD MORTALITY
dc.subject	CHILD MORTALITY RATES
dc.subject	CHRONIC DISEASES
dc.subject	CHRONIC MALNUTRITION
dc.subject	CLEANLINESS
dc.subject	CLINICAL INDICATORS
dc.subject	CLINICS
dc.subject	CONTRACTS WITH PROVIDERS
dc.subject	DEATH RATES
dc.subject	DEATHS
dc.subject	DECISION MAKING
dc.subject	DELIVERY SYSTEM
dc.subject	DOCTORS
dc.subject	DRUGS
dc.subject	ECONOMIC ANALYSIS
dc.subject	EQUITY IN ACCESS
dc.subject	EXERCISES
dc.subject	EXPENDITURES
dc.subject	FAMILY PLANNING
dc.subject	FEE-FOR-SERVICE
dc.subject	FEE-FOR-SERVICE PAYMENT
dc.subject	FINANCIAL BARRIERS
dc.subject	FINANCIAL IMPACT
dc.subject	FINANCIAL INCENTIVE
dc.subject	FINANCIAL INCENTIVES
dc.subject	FINANCIAL INFORMATION
dc.subject	FINANCIAL MANAGEMENT
dc.subject	FINANCIAL PRESSURE
dc.subject	FINANCIAL RESOURCES
dc.subject	FINANCIAL RISK
dc.subject	FINANCIAL SITUATION
dc.subject	GLOBAL BUDGETS
dc.subject	GLOBAL DEVELOPMENT
dc.subject	GROSS DOMESTIC PRODUCT
dc.subject	HEALTH BUDGETS
dc.subject	HEALTH CARE CENTERS
dc.subject	HEALTH CARE DELIVERY
dc.subject	HEALTH CARE DURING PREGNANCY
dc.subject	HEALTH CARE FACILITIES
dc.subject	HEALTH CARE FACILITY
dc.subject	HEALTH CARE FINANCING
dc.subject	HEALTH CARE PROVIDERS
dc.subject	HEALTH CARE SERVICES
dc.subject	HEALTH CARE WORKERS
dc.subject	HEALTH CENTERS
dc.subject	HEALTH EXPENDITURE
dc.subject	HEALTH EXPENDITURES
dc.subject	HEALTH FACILITIES
dc.subject	HEALTH FINANCING
dc.subject	HEALTH FINANCING REFORM
dc.subject	HEALTH FOR ALL
dc.subject	HEALTH INDICATORS
dc.subject	HEALTH INFORMATION
dc.subject	HEALTH INFORMATION SYSTEM
dc.subject	HEALTH MANAGEMENT
dc.subject	HEALTH ORGANIZATION
dc.subject	HEALTH OUTCOME INDICATORS
dc.subject	HEALTH OUTCOMES
dc.subject	HEALTH PROJECT
dc.subject	HEALTH PROMOTION
dc.subject	HEALTH RESULTS
dc.subject	HEALTH SECTOR
dc.subject	HEALTH SERVICE
dc.subject	HEALTH SERVICE PROVIDERS
dc.subject	HEALTH SERVICES
dc.subject	HEALTH SPECIALIST
dc.subject	HEALTH SPENDING
dc.subject	HEALTH STATUS
dc.subject	HEALTH SYSTEM
dc.subject	HEALTH SYSTEMS
dc.subject	HEALTH WORKERS
dc.subject	HEALTH WORKFORCE
dc.subject	HEALTHCARE
dc.subject	HIV
dc.subject	HOSPITAL
dc.subject	HOSPITAL ADMISSION
dc.subject	HOSPITAL CARE
dc.subject	HOSPITAL DISCHARGE
dc.subject	HOSPITAL MANAGERS
dc.subject	HOSPITALIZATION
dc.subject	HOSPITALS
dc.subject	HOUSEHOLD LEVEL
dc.subject	HR
dc.subject	HUMAN DEVELOPMENT
dc.subject	IMMUNIZATION
dc.subject	INCENTIVE PAYMENTS
dc.subject	INCOME
dc.subject	INCOME COUNTRIES
dc.subject	INCOME GROUPS
dc.subject	INDIVIDUAL HEALTH
dc.subject	INFANT
dc.subject	INFANT DEATH
dc.subject	INFANT MORTALITY
dc.subject	INFANT MORTALITY RATE
dc.subject	INFANTS
dc.subject	INFORMAL PAYMENTS
dc.subject	INFORMATION CAMPAIGNS
dc.subject	INFORMATION SYSTEMS
dc.subject	INPATIENT ADMISSION
dc.subject	INTEGRATION
dc.subject	IODINE DEFICIENCY
dc.subject	LABORATORY SERVICES
dc.subject	LEGAL FRAMEWORK
dc.subject	LIFE EXPECTANCY
dc.subject	LIVE BIRTHS
dc.subject	LIVING STANDARDS
dc.subject	LOCAL AUTHORITIES
dc.subject	LOCAL GOVERNMENTS
dc.subject	LOW BIRTH WEIGHT
dc.subject	LOW INCOME
dc.subject	LOW-INCOME COUNTRIES
dc.subject	LOW-INCOME COUNTRY
dc.subject	LOW-INCOME SETTINGS
dc.subject	MANAGED CARE
dc.subject	MANAGED CARE PLANS
dc.subject	MATERNAL MORTALITY
dc.subject	MATERNAL MORTALITY RATE
dc.subject	MATERNAL MORTALITY RATIO
dc.subject	MEDICAL DATA
dc.subject	MEDICAL EQUIPMENT
dc.subject	MEDICAL EXAMINATIONS
dc.subject	MEDICAL RECORDS
dc.subject	MEDICAL RESOURCES
dc.subject	MEDICAL STATISTICS
dc.subject	MEDICAL SUPPLIES
dc.subject	MEDICINES
dc.subject	MILLENNIUM DEVELOPMENT GOALS
dc.subject	MINISTRY OF HEALTH
dc.subject	MORTALITY
dc.subject	MOTHER
dc.subject	NATIONAL GOVERNMENT
dc.subject	NATIONAL HEALTH
dc.subject	NATIONAL HEALTH SERVICE
dc.subject	NATIONAL LEVEL
dc.subject	NEEDS ASSESSMENT
dc.subject	NUTRITION
dc.subject	ORAL REHYDRATION THERAPY
dc.subject	OUTPATIENT CARE
dc.subject	OUTPATIENT SERVICES
dc.subject	PATIENT
dc.subject	PATIENT SATISFACTION
dc.subject	PATIENT SURVEYS
dc.subject	PATIENTS
dc.subject	PEDIATRICS
dc.subject	PEER PRESSURE
dc.subject	PHARMACY
dc.subject	PHYSICIAN
dc.subject	PHYSICIANS
dc.subject	POCKET PAYMENTS
dc.subject	POOR HEALTH
dc.subject	POPULATION SIZE
dc.subject	PRACTITIONERS
dc.subject	PREGNANCY
dc.subject	PREGNANT WOMEN
dc.subject	PRENATAL CARE
dc.subject	PREVENTIVE CARE
dc.subject	PRIMARY HEALTH CARE
dc.subject	PRIVATE CLINICS
dc.subject	PROFESSIONAL ASSOCIATIONS
dc.subject	PROGRESS
dc.subject	PROVIDER PAYMENT
dc.subject	PROVISION OF CARE
dc.subject	PROVISION OF HEALTH CARE
dc.subject	PUBLIC ADMINISTRATION
dc.subject	PUBLIC EXPENDITURE
dc.subject	PUBLIC HEALTH
dc.subject	PUBLIC HEALTH EXPENDITURE
dc.subject	PUBLIC HEALTH SERVICES
dc.subject	PUBLIC HOSPITALS
dc.subject	PUBLIC SECTOR
dc.subject	QUALITY IMPROVEMENT
dc.subject	QUALITY OF CARE
dc.subject	QUALITY OF HEALTH
dc.subject	QUALITY OF HEALTH CARE
dc.subject	QUALITY OF SERVICES
dc.subject	REFERRALS
dc.subject	REMITTANCES
dc.subject	REPRODUCTIVE HEALTH
dc.subject	RESOURCE ALLOCATION
dc.subject	RESOURCE CONSTRAINTS
dc.subject	RESOURCE USE
dc.subject	RISK FACTORS
dc.subject	RURAL AREAS
dc.subject	SERVICE DELIVERY
dc.subject	SERVICE PROVISION
dc.subject	SOCIAL SECURITY
dc.subject	SURGERY
dc.subject	TREATMENTS
dc.subject	TUBERCULOSIS
dc.subject	UNDER FIVE MORTALITY
dc.subject	VACCINATION
dc.subject	VISITS
dc.subject	WOMENS HEALTH
dc.subject	WOMENS HEALTH CARE
dc.subject	WORKERS
dc.subject	WORLD HEALTH ORGANIZATION
dc.title	Tajikistan - Feasibility Study for Results-Based Financing (RBF) In the Health Sector
dc.type	Economic & Sector Work :: Other Health Study
dc.coverage	Europe and Central Asia
dc.coverage	Eastern Europe
dc.coverage	Commonwealth of Independent States
dc.coverage	Central Asia
dc.coverage	Asia
dc.coverage	Tajikistan