Working Paper: NBER ID: w19046
Authors: Paul Gertler; Christel Vermeersch
Abstract: We nested a large-scale field experiment into the national rollout of the introduction of performance pay for medical care providers in Rwanda to study the effect of incentives for health care providers. In order to identify the effect of incentives separately from higher compensation, we held constant compensation across treatment and comparison groups - a portion of the treatment group's compensation was based on performance whereas the compensation of the comparison group was fixed. The incentives led to a 20% increase in productivity, and significant improvements in child health. We also find evidence of a strong complementarity between performance incentives and baseline provider skill.
Keywords: performance incentives; health outcomes; provider productivity; Rwanda
JEL Codes: I11; J33; O12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Productivity increase (O49) | Child health outcomes improvement (I14) |
| Provider skill (I11) | Effectiveness of performance incentives (J33) |
| Performance incentives (J33) | Productivity increase (O49) |
| Performance incentives (J33) | Weight-for-age Z-scores increase (I14) |
| Performance incentives (J33) | Height-for-age Z-scores increase (O15) |
| Performance incentives (J33) | Reduction in inefficiency (D61) |