Health Systems Strengthening Via Performance-Based Aid: Creating Incentives to Perform and to Measure Results

Amanda Glassman and
Chief Operating Officer and Senior Fellow, Center for Global Development
Amanda Glassman Former Brookings Expert, Chief Operating Officer and Senior Fellow - Center for Global Development
Rena Eichler

September 30, 2008


The new global health partnerships, such as the Global Alliance for Vaccines and Immunization, the Global Fund for AIDS, TB, and Malaria and UNITAID have fundamentally changed the landscape and scale of funding for global health initiatives since 2000. As many more billions of dollars flow into these organizations and through traditional bilateral and multilateral funders of health assistance, strengthening the connection between the financial flows and results increases in importance. The experience with performance-based assistance for health projects has increased in recent years, presenting the opportunity for donors to consider some of the lessons and to build them into their own programs. This paper reviews some of the experience and derives lessons for shifting more funding into performance-based instruments.