Rob Ubaidur, Alam Mohammad Masudul
The Population Council, Dhaka, Bangladesh.
Int Q Community Health Educ. 2013;34(4):303-12. doi: 10.2190/IQ.34.4.b.
Poor motivation of providers, primarily caused by low remuneration and/or non-existence of financial incentives, has been a key challenge to improve the quality of maternal health services in the public sector health facilities in rural Bangladesh. An operations research study examined the impact of performance-based incentive for service providers at the institutional level to improve the quality of maternal health services. Quality of care was assessed through monitoring visits of professionals from higher-level health facilities, which contributed to improved service provision within the facilities. Quality scores of the facilities increased from 55% to 78% in 14 months of intervention with significant improvement in antenatal care, postnatal counseling, and institutional delivery (p < 0.01). Importantly, client satisfaction increased remarkably in the intervention facilities. Performance-based incentive has the potential for motivating service providers in improving the quality of maternal health services and for increasing the utilization of facilities for maternal health services in Bangladesh.
提供者积极性不高，主要是由于薪酬低和/或缺乏经济激励措施，这一直是提高孟加拉国农村地区公共部门卫生设施中孕产妇保健服务质量的关键挑战。一项运筹学研究考察了机构层面基于绩效的激励措施对提高孕产妇保健服务质量的影响。通过上级卫生设施专业人员的监督访问来评估护理质量，这有助于改善设施内的服务提供情况。在14个月的干预期间，设施的质量得分从55%提高到了78%，产前护理、产后咨询和机构分娩均有显著改善（p<0.01）。重要的是，干预设施中的客户满意度显著提高。基于绩效的激励措施有潜力激励服务提供者提高孕产妇保健服务质量，并增加孟加拉国孕产妇保健服务设施的利用率。
