An innovative pay-for-performance (P4P) strategy for improving malaria management in rural Kenya: protocol for a cluster randomized controlled trial.
An innovative pay-for-performance (P4P) strategy for improving malaria management in rural Kenya: protocol for a cluster randomized controlled trial.
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DOI：
10.1186/1748-5908-8-48
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发表时间：
2013-05-08
期刊：
影响因子：
--
通讯作者：
O'Meara WP
中科院分区：
文献类型：
--
作者：
Menya D;Logedi J;Manji I;Armstrong J;Neelon B;O'Meara WP
In high-resource settings, ‘pay-for-performance’ (P4P) programs have generated interest as a potential mechanism to improve health service delivery and accountability. However, there has been little or no experimental evidence to guide the development or assess the effectiveness of P4P incentive programs in developing countries. In the developing world, P4P programs are likely to rely, at least initially, on external funding from donors. Under these circumstances, the sustainability of such programs is in doubt and needs assessment. We describe a cluster-randomized controlled trial underway in 18 health centers in western Kenya that is testing an innovative incentive strategy to improve management of an epidemiologically and economically important problem—diagnosis and treatment of malaria. The incentive scheme in this trial promotes adherence to Ministry of Health guidelines for laboratory confirmation of malaria before treatment, a priority area for the Ministry of Health. There are three important innovations that are unique to this study among those from other resource-constrained settings: the behavior being incentivized is quality of care rather than volume of service delivery; the incentives are applied at the facility-level rather than the individual level, thus benefiting facility infrastructure and performance overall; and the incentives are designed to be budget-neutral if effective. Linking appropriate case management for malaria to financial incentives has the potential to improve patient care and reduce wastage of expensive antimalarials. In our study facilities, on average only 25% of reported malaria cases were confirmed by laboratory diagnosis prior to the intervention, and the total treatment courses of antimalarials dispensed did not correspond to the number of cases reported. This study will demonstrate whether facility rather than individual incentives are compelling enough to improve case management, and whether these incentives lead to offsetting cost-savings as a result of reduced drug consumption. ClinicalTrials.gov Registration Number NCT01809873
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DOI：
10.1136/bmj.c930
发表时间：
2010-03-05
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Ansah EK;Narh-Bana S;Epokor M;Akanpigbiam S;Quartey AA;Gyapong J;Whitty CJ
通讯作者：
Whitty CJ
影响因子：
11.8
作者：
John CC;Riedesel MA;Magak NG;Lindblade KA;Menge DM;Hodges JS;Vulule JM;Akhwale W
通讯作者：
Akhwale W
坦桑尼亚初级卫生保健水平上，儿童疟疾临床和显微镜诊断培训对抗疟疾药物处方和健康结果的影响：一项随机对照试验。
影响因子：
3
作者：
Ngasala B;Mubi M;Warsame M;Petzold MG;Massele AY;Gustafsson LL;Tomson G;Premji Z;Bjorkman A
通讯作者：
Bjorkman A
影响因子：
3.7
作者：
Uzochukwu BS;Onwujekwe E;Ezuma NN;Ezeoke OP;Ajuba MO;Sibeudu FT
通讯作者：
Sibeudu FT
影响因子：
158.5
作者：
Campbell, Stephen;Reeves, David;Roland, Martin
通讯作者：
Roland, Martin