To support this development, there will be some experimentation with Pay-for-Performance (P4P) schemes that tie a portion of provider payments to performance based on measures of quality.
Contrary to the directives from the Ministry of Health, the district administration ended up paying bonuses to all facilities at a flat rate, which means of course that the payments were not performance based.
ASHAs are to be supported and supervised by ASHA facilitators and Auxiliary Nurse Midwives (ANMs) of the Primary Health Center PHCC) through the replenishment of supplies, regular payment of performance-based incentives, supervision during field visits, and mentoring (3).
A number of other changes supporting the transformation of the system were also made such as introduction of a performance based payment system, changes in the reimbursement and pricing policies and others.
Finally, there is the issue of funding, and we have two very insightful quotes about the financial disincentives for research: the negative effects of new performance based payment system and the decline in support from pharmaceutical companies.
In a 2011 telegram, Kenya's Ministry of Public Health and Sanitation stated 'where funds are available community health workers shall be entitled to a payment of Ksh.2000 per month [approximately USD$255] as performance based incentive' [ 23].
Since performance based REDD+ carbon payments decrease over time (as deforestation rates drop and for each saved ha of forest payments occur once), investments in REDD+ implementation have a crucial role in triggering sustainable land use systems by investing in the underlying assets and the generation of sustainable revenue streams to compensate for opportunity costs of land use change.
National level stakeholders suggested conditional transfer of funds and performance based bonus payments to health facilities that can be utilized for motivation and purchasing needed materials.
Performance based payment incentives are now a routine part of many health economies.
In a performance based payment system this would correspond to an underestimated REDD-credit of 2,400 US$ per km2, if we assume that C makes up 50% of AGB and that the payment is 5 US$ per ton CO2.
In a performance based payment system this would correspond to an underestimated REDD-credit of 2,400 US$ per km, if we assume that C makes up 50% of AGB and that the payment is 5 US$ per ton CO2.
