Rewarding Provider Performance to Enable a Healthy Start to Life : Evidence from Argentina's Plan Nacer
Argentina's Plan Nacer provides insurance for maternal and child health care to uninsured families. The program allocates funding to provinces based on enrollment of beneficiaries and adds performance incentives based on indicators of the use...
| Main Authors: | , , |
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2014
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2014/05/19546892/rewarding-provider-performance-enable-healthy-start-life-evidence-argentinas-plan-nacer http://hdl.handle.net/10986/18801 |
| Summary: | Argentina's Plan Nacer provides
insurance for maternal and child health care to uninsured
families. The program allocates funding to provinces based
on enrollment of beneficiaries and adds performance
incentives based on indicators of the use and quality of
maternal and child health care services and health outcomes.
The provinces use these resources to pay health facilities
to provide maternal and child health care services to
beneficiaries. This paper analyzes the impact of Plan Nacer
on birth outcomes. The analysis uses data from the universe
of birth records in seven Argentine provinces for 2004 to
2008 and exploits the geographic phasing in of Plan Nacer
over time. The paper finds that the program increases the
use and quality of prenatal care as measured by the number
of visits and the probability of receiving a tetanus
vaccine. Beneficiaries' probability of low birth-weight
is estimated to be reduced by 19 percent. Beneficiaries have
a 74 percent lower chance of in-hospital neonatal mortality
in larger facilities and approximately half this reduction
comes from preventing low birth weight and half from better
postnatal care. The analysis finds that the cost of saving a
disability-adjusted life year through the program was $814,
which is highly cost-effective compared with
Argentina's $6,075 gross domestic product per capita
over this period. Although there are small negative
spillover effects on prenatal care utilization of
non-beneficiary populations in clinics covered by Plan
Nacer, no spillover is found on their birth outcomes. |
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