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Bringing it all together: Designing and Implementing RBF

Bringing it all together: Designing and Implementing RBF. Benjamin Loevinsohn World Bank October 2008. A Few Thoughts to Start. Don’t Panic : RBF has worked in difficult situations, not everything has to be perfect, be creative!

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Bringing it all together: Designing and Implementing RBF

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  1. Bringing it all together: Designing and Implementing RBF Benjamin Loevinsohn World Bank October 2008

  2. A Few Thoughts to Start • Don’t Panic: RBF has worked in difficult situations, not everything has to be perfect, be creative! • Be Systematic: Write things down in a contract and a manual/plan/guide • The Limits of Planning: Endless planning and analysis can get in the way of action & learning • Humility:a) don’t be too sure of things b) knowledge must be larger than our experience c) give people at local levels sufficient autonomy d) keep learning, evaluating, adapting

  3. Conceptually, RBF is Simple • An objective with clear indicators • Measurement of the indicators • Payment linked to change in indicators • An entity to manage the process

  4. Why RBF Ought to Work • Focus on outputs/outcomes – NOT INPUTS • People respond predictably to rewards • Signals importance of indicators to the recipient – people want to do a good job • Provides recognition of important work & embarrassment if targets not achieved • Gets everyone to focus on measurement issues and use of data for management

  5. Possible Problems with RBF • Is it effective? Does it work in the real world? – points out need for rigorous evaluation. • Is it cost effective? – keep costs low • Does its effectiveness degrade over time? – ensure that payments remain results based • Is it equitable? – means to target the poor • Unintended consequences? – evaluate quality, equity, non-RBF indicators

  6. Beyond Paying Health Workers- Other Opportunities for RBF • BRAC approach to paying health educators • Recruiting district health managers on a performance-based contract • CCT for institutional delivery • Making social marketing contracts performance-based • Drug supply management contracts • LLIN distribution and use contracts

  7. 1. Diagnose Problem 2. Determine Recipients 7. Develop evaluation & learning strategy 3. Design indicators & targets, decide how to measure them 6. Identify key stakeholders 4. Determine payment mechanism 5. Establish entity that will manage RBF The RBF Implementation Cycle

  8. THANK YOU!

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