title: Using provider performance incentives to increase HIV testing and counseling services in Rwanda.
abstract: Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient.
authors.affiliation: Development Research Group, The World Bank, United States. Electronic address: ddewalque@worldbank.org.
authors.forename: Damien
authors.initials: D
authors.lastname: de Walque
authors.affiliation: Haas School of Business, University of California, Berkeley, United States.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Gertler
authors.affiliation: National Institute of Public Health, Cuernavaca, Mexico.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bautista-Arredondo
authors.affiliation: National Institute of Public Health, Cuernavaca, Mexico.
authors.forename: Ada
authors.initials: A
authors.lastname: Kwan
authors.affiliation: The World Bank, United States.
authors.forename: Christel
authors.initials: C
authors.lastname: Vermeersch
authors.affiliation: Camris International, United States.
authors.forename: Jean
authors.initials: J
authors.lastname: de Dieu Bizimana
authors.affiliation: Ministry of Health, Government of Rwanda, Kigali, Rwanda; Senior Lecturer, Harvard Medical School, Department of Global Health and Social Medicine; Clinical Professor of Pediatrics, Geisel School of Medicine at Dartmouth College, United States.
authors.forename: Agnès
authors.initials: A
authors.lastname: Binagwaho
authors.affiliation: School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
authors.forename: Jeanine
authors.initials: J
authors.lastname: Condo
mesh_terms: D015492:AIDS Serodiagnosis / Q000191:economics* / Q000706:statistics & numerical data; D003376:Counseling / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012052:Reimbursement, Incentive / Q000458:organization & administration; D012432:Rwanda
keywords: Africa; Couple testing; HIV testing and counseling; Health human resources; Performance-based financing