title: Performance-based financing: the same is different.
abstract: Although it is increasingly acknowledged within the Performance-Based Financing (PBF) research community that PBF is more than just payments based on outputs verified for quality, this narrow definition of PBF is still very present in many studies and evaluations. This leads to missed opportunities, misunderstandings and an unhelpful debate. Therefore, we reinforce the claim that PBF should be viewed as a reform package focused on targeted services with many different aspects that go beyond the health worker level. Failing to acknowledge the importance of the different elements of PBF negatively influences the task of practitioners, researchers and policymakers alike. After making the case for this wider definition, we propose three research pathways (describing, understanding and framing PBF) and give a short and tentative starting point for future research, leaving the floor open for more in-depth discussions. From these three vantage points it appears that when it comes to PBF 'the same is different'. Notwithstanding the increased complexity due to the use of the wider definition, progress on these three different research pathways will strongly improve our knowledge, lead to better adapted PBF programs and create a more nuanced debate on PBF.
authors.affiliation: Institute of Development Policy and Management, University of Antwerp, Lange Sint-Annastraat 7, 2000 Antwerp, Belgium.|Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Renmans
authors.affiliation: Institute of Development Policy and Management, University of Antwerp, Lange Sint-Annastraat 7, 2000 Antwerp, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Holvoet
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Criel
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
authors.forename: Bruno
authors.initials: B
authors.lastname: Meessen
mesh_terms: D003906:Developing Countries / Q000191:economics; D018166:Health Care Reform / Q000379:methods; D006291:Health Policy; D061889:Healthcare Financing; D012052:Reimbursement, Incentive
keywords: Developing countries; health care reform; health financing; health policy; research