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Table 3 Effect of P4P on institutional delivery and on potential mediators

From: Understanding causal pathways within health systems policy evaluation through mediation analysis: an application to payment for performance (P4P) in Tanzania

 

Effect of P4P (% change)

Observations

Maternal care outcomes

Facility-based delivery

8.2***

(3.6; 12.8)

5747

Public facility delivery

6.5**

(1.3; 11.7)

5747

Taken at least 2 doses of anti-malaria drug

10.3***

(4.4; 16.1)

4759

Potential mediators

Health workers received supervision visit in the last 90 days

18.0**

(4.0; 32.0)

5100

Drug stock-out index-general (0–1 index)

−17.2***BS

(−28.6;−5.8)

5659

Drugs at delivery stock-out index (0–1 index)

−27.0***BS

(−43.4;−10.6)

5639

Oxytocin injection stock-out last 90 days

−36.2***BS

(−55.9;−16.4)

5618

Ergomentrin injection stock-out last 90 days

−26.1**

(−48.2;−4.0)

5562

Medical supplies stock-out index (0–1 index)

−14.8***BS

(−24.8;−4.9)

5278

Service delivery disrupted due to broken equipment last 90 days

−14.9**

(−29.3;−0.4)

5602

Health worker knowledge

18.8***BS

(10.4; 27.2)

5461

Kindness ranks for health workers at delivery

4.3*

(−0.4; 9.0)

5747

Percentage of women who paid for delivery in a HF

−4.5*

(−9.5; 0.6)

5750

  1. BS Significant at 5% level with Bonferroni adjusted p value for multiple outcomes: Bonferroni adjusted p value for potential mediators within three major groups: Financing 0.0047, governance 0.0017, human resources 0.0414. Indicators within each category in Table 1 have been grouped into: governance (strengthened supervision, active governing committees, increased outreach activities), financing (availability of drugs, medical supplies and equipment, increase insurance enrolment, reduction in user charges), and human resources (health worker more motivated and knowledgeable, improved patient provider interactions, adherence to clinical protocol). 95% confidence intervals in parentheses. Percent sign (%) indicates percentage points change
  2. *p < 0.10; **p < 0.05; ***p < 0.01