Table 2

Inclusion and exclusion criteria

Inclusion criteriaExclusion criteria
The exposure (intervention) is a P4P intervention. These schemes had to target healthcare providers and/or managers (supply-side), incentives had to be financial and cash disbursement had to be varied accordingly to performance, defined as the achievement of quantitative indicators for selected healthcare services, quality-related indicators or both quantity-related and quality-related indicators. When performance is linked to quantitative outputs, it has to be related to ‘selected healthcare services’ as such criterion allows one to discriminate between P4P and fee for service mechanisms.Schemes targeting beneficiaries of health services (ie, demand-side incentives); Supply-side P4P schemes outside of the health sector; P4P schemes that did not specifically target selective health services and, therefore, were not distinguishable from fee for service schemes
The study should isolate (or attempt to isolate) the effects of P4P programmes from that of broader policy reforms, which often encompass the P4P reform.Studies which do not attempt to isolate the effects of P4P from broader reforms.
The evaluation of pilot projects will be included in the study.Studies of the ‘potential’ implementation of P4P strategies not yet in place.
The study outcome has to be either a quantitative or qualitative measure (or both) of the impact of the P4P initiative on one or more health system functions described in the initial programme theory (figure 1) or other relevant mechanisms or contextual factors affecting outcomes.Studies that only examine impact on ultimate service utilisation and health outcomes and do not examine mechanisms and/or context.
The study should report on primary data sources. Where the study refers to different sources of evidence for primary data (eg, in the case of systematic reviews), the primary source of information will be retrieved and explored.Studies that do not report primary data sources (eg, commentaries or reviews), though these will be screened for relevant additional references.
The intervention had to be implemented in an LMIC, as defined by the World Bank.56 Studies in high-income settings.
Studies in English, French, Portuguese or Spanish.Studies in languages other than English, French, Portuguese or Spanish
  • FFS, fee-for-service; LMIC, low  and middle  income countries; P4P, payment for performance.