The Effectiveness of Pay-for-Performance Contracts with Non-Governmental Organizations in Afghanistan – Results of a Controlled Interrupted Time Series Analysis


In many contexts, including fragile settings like Afghanistan, the coverage of basic health services is low. To address these challenges there has been considerable interest in working with NGOs and examining the effect of financial incentives on service providers. The Government of Afghanistan has used contracting with NGOs for more than 15 years and in 2019 introduced pay-for-performance (P4P) into the contracts. This study examines the impact of P4P on health service delivery in Afghanistan.


Samad, D., Hamid, B., Sayed, G. D., Liu, Y., Zeng, W., Rowe, A. K., & Loevinsohn, B. (2023). The effectiveness of pay-for-performance contracts with non-governmental organizations in Afghanistan–results of a controlled interrupted time series analysis. BMC Health Services Research23(1), 1-12.

Global Health Faculty Publications