Should performance-based incentives be used to motivate health care providers? Views of health sector managers in Cambodia, China and Pakistan.

Khan, M; Roychowdhury, I; Meghani, A; Hashmani, F; Borghi, J; Liverani, M

Should performance-based incentives be used to motivate health care providers? Views of health sector managers in Cambodia, China and Pakistan.

Khan, M Roychowdhury, I Meghani, A Hashmani, F

Borghi, J Liverani, M

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Publisher:: CAMBRIDGE UNIV PRESS
Publication Type:: Journal Article
Citation:: Health economics, policy, and law, 2020, 15, (2), pp. 247-260
Issue Date:: 2020-04

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Field	Value	Language
dc.contributor.author	Khan, M
dc.contributor.author	Roychowdhury, I
dc.contributor.author	Meghani, A
dc.contributor.author	Hashmani, F https://orcid.org/0000-0001-6055-4337
dc.contributor.author	Borghi, J
dc.contributor.author	Liverani, M
dc.date.accessioned	2021-04-14T03:55:31Z
dc.date.available	2021-04-14T03:55:31Z
dc.date.issued	2020-04
dc.identifier.citation	Health economics, policy, and law, 2020, 15, (2), pp. 247-260
dc.identifier.issn	1744-1331
dc.identifier.issn	1744-134X
dc.identifier.uri	http://hdl.handle.net/10453/148082
dc.description.abstract	This study qualitatively investigates what factors apart from or in addition to financial incentives can encourage better performance of frontline health care providers. We interviewed health sector managers in Pakistan, Cambodia and China, and they highlighted many potential limitations in the applicability of financial incentives in their contexts. There was a consistent view that providers are not always primarily driven by monetary rewards and that non-monetary rewards - such as recognition from direct supervisors and career development - could have a greater influence on performance. Managers also highlighted several challenges related to the design and implementation of performance management schemes: supervisors may not have performance information necessary to determine which agents to reward; when performance information is available, organisational culture may value other attributes such as social ties or years of experience; finally, concentration of power at higher levels of the health system can reduce supervisors' ability to manage performance, rewards and accountability. Although health sector managers were enthusiastic about measures to improve performance of providers, our study indicated that specific social, cultural and health system factors may mean that non-monetary rewards and structural changes to support a more transparent and meritocratic working environment should also be considered.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	CAMBRIDGE UNIV PRESS
dc.relation.ispartof	Health economics, policy, and law
dc.relation.isbasedon	10.1017/s1744133118000506
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1402 Applied Economics, 1605 Policy and Administration, 1801 Law
dc.subject.classification	Health Policy & Services
dc.subject.mesh	Humans
dc.subject.mesh	Motivation
dc.subject.mesh	Health Personnel
dc.subject.mesh	Workplace
dc.subject.mesh	Reimbursement, Incentive
dc.subject.mesh	Organizational Culture
dc.subject.mesh	Cambodia
dc.subject.mesh	Pakistan
dc.subject.mesh	China
dc.subject.mesh	Cambodia
dc.subject.mesh	China
dc.subject.mesh	Health Personnel
dc.subject.mesh	Humans
dc.subject.mesh	Motivation
dc.subject.mesh	Organizational Culture
dc.subject.mesh	Pakistan
dc.subject.mesh	Reimbursement, Incentive
dc.subject.mesh	Workplace
dc.title	Should performance-based incentives be used to motivate health care providers? Views of health sector managers in Cambodia, China and Pakistan.
dc.type	Journal Article
utslib.citation.volume	15
utslib.location.activity	England
utslib.for	1402 Applied Economics
utslib.for	1605 Policy and Administration
utslib.for	1801 Law
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2021-04-14T03:55:30Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	15
utslib.citation.issue	2

Abstract:

This study qualitatively investigates what factors apart from or in addition to financial incentives can encourage better performance of frontline health care providers. We interviewed health sector managers in Pakistan, Cambodia and China, and they highlighted many potential limitations in the applicability of financial incentives in their contexts. There was a consistent view that providers are not always primarily driven by monetary rewards and that non-monetary rewards - such as recognition from direct supervisors and career development - could have a greater influence on performance. Managers also highlighted several challenges related to the design and implementation of performance management schemes: supervisors may not have performance information necessary to determine which agents to reward; when performance information is available, organisational culture may value other attributes such as social ties or years of experience; finally, concentration of power at higher levels of the health system can reduce supervisors' ability to manage performance, rewards and accountability. Although health sector managers were enthusiastic about measures to improve performance of providers, our study indicated that specific social, cultural and health system factors may mean that non-monetary rewards and structural changes to support a more transparent and meritocratic working environment should also be considered.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/148082