Pay for Performance: A Reflection on How a Global Perspective Could Enhance Policy and Research

Document Type : Perspective


1 Health, Organisation, Policy and Economics (HOPE), Centre for Primary Care and Health Service Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

2 Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK

3 School of Politics and International Studies (POLIS), University of Leeds, Leeds, UK

4 Department of Economics, University of Bath, Bath, UK

5 Training and Research Support Centre (TARSC), Harare, Zimbabwe

6 Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK


Pay-for-performance (P4P) is the provision of financial incentives to healthcare providers based on pre-specified performance targets. P4P has been used as a policy tool to improve healthcare provision globally. However, researchers tend to cluster into those working on high or low- and middle-income countries (LMICs), with still limited knowledge exchange, potentially constraining opportunities for learning from across income settings. We reflect here on some commonalities and differences in the design of P4P schemes, research questions, methods and data across income settings. We highlight how a global perspective on knowledge synthesis could lead to innovations and further knowledge advancement.


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Volume 9, Issue 9
September 2020
Pages 365-369
  • Receive Date: 15 November 2019
  • Revise Date: 07 February 2020
  • Accept Date: 15 February 2020
  • First Publish Date: 01 September 2020