Title: Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs
Abstract: This article surveys experience with performance pay in developing country health programs. In doing so, it focuses on four key conceptual issues: (1) what to reward, (2) who to reward, (3) how to reward, and (4) what unintended consequences might performance incentives create. The use of performance pay has outpaced growth in the corresponding empirical evidence has been highlighted. Moreover, very little research on performance incentives focuses on the underlying conceptual issues that are outlined. Taken together, these are considered to be important constraints to the design of better performance incentives in low- and middle-income country health programs.