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Table 4 Effect of P4P and potential mediators on maternal care outcomes (results from Eq. 3)

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

 

Facility-based delivery (% change)

Public facility delivery (% change)

Taken at least 2 doses of anti-malaria drug (% change)

Effect of P4P without mediators

8.2***

(3.6; 12.8)

6.5**

(1.3; 11.7)

10.3***

(4.4; 16.1)

Effect of P4P mediated by

Health worker received supervision in the last 90 days

 - Coefficient on P4P (B 1 )

5.6**

(4.0; 10.7)

4.3

(−1.5; 10.2)

10.7***

(4.1; 17.3)

 - Coefficient on mediator (B 4 )

3.1

(-2.3; 8.5)

0.8

(-6.6; 8.2)

8.5***

(2.4; 14.6)

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

 - Coefficient on P4P (B1)

7.8***

(3.0; 12.6)

5.5**

(0.2; 10.9

11.5***

(5.5; 17.4)

 - Coefficient on mediator (B4)

−3.6

(−9.2; 1.9)

−2.9

(−9.0; 3.2)

7.0

(−1.8; 15.8)

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

 - Coefficient on P4P (B1)

7.4***

(2.5; 12.3)

4.6*

(−0.6; 9.9)

10.6***

(4.6; 16.5)

 - Coefficient on mediator (B4)

−3.2

(−7.6; 1.2)

−4.3*

(−9.0; 0.3)

0.8

(−5.6; 7.2)

Oxytocin injection stock-out last 90 days

 - Coefficient on P4P (B 1 )

6.3***

(1.5; 11.1)

3.8

(−1.6; 9.1)

10.7***

(4.6; 16.9)

 - Coefficient on mediator (B 4 )

−4.9***

(−8.4;−1.4)

−5.3***

(−8.9;−1.7)

0.9

(−4.2; 6.1)

Ergometrin injection stock-out last 90 days

 - Coefficient on P4P (B1)

8.1***

(2.8; 13.4)

5.7**

(0.1; 11.4)

10.8***

(4.7; 16.8)

 - Coefficient on mediator (B4)

1.0

(−3.7; 5.6)

0.5

(−4.4; 5.5)

0.7

(−4.0; 5.4)

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

 - Coefficient on P4P (B1)

8.0***

(3.1; 12.9)

4.9*

(−0.8; 10.6)

10.9***

(4.3; 17.5)

 - Coefficient on mediator (B4)

−6.8

(−16.5; 2.8)

−8.0

(−18.2; 2.2)

1.3

(−9.8; 12.4)

Service delivery disrupted due to broken equipment last 90 days

 - Coefficient on P4P (B1)

7.7***

(3.0; 12.4)

5.4**

(0.1; 10.6)

9.9***

(3.8; 16.0)

 - Coefficient on mediator (B4)

−3.7

(−8.8; 1.5)

−3.7

(−10.3; 2.9)

−0.5

(−8.8; 7.7)

Health worker knowledge

 - Coefficient on P4P (B1)

8.6***

(4.0; 13.2)

6.6**

(1.5; 11.7;)

11.2***

(4.7; 17.6)

 - Coefficient on mediator (B4)

−5.6

(−14.5; 3.2)

−1.7

(−12.0; 8.7)

−3.4

(−17.1; 10.3)

Health worker kindness at delivery

 - Coefficient on P4P (B 1 )

4.3

(−2.2; 10.8)

3.3

(−3.2; 9.9)

10.0***

(4.0; 15.9)

 - Coefficient on mediator (B 4 )

9.1***

(6.4; 11.8)

8.0***

(4.7; 10.3)

0.3

(−1.9; 26)

Percentage of women who paid for delivery in a HF

   

 - Coefficient on P4P (B 1 )

4.0

(−2.5; 10.5)

1.5

(−5.0; 8.0)

9.4***

(3.5; 15.3)

 - Coefficient on mediator (B 4 )

−93.5***

(−122.7;−64.4)

−112.9***

(−141.0;−84.8)

−17.9*

(−35.8; 0.1)

Taken at least 2 doses of anti-malaria drug during pregnancy

 - Coefficient on P4P (B1)

9.3***

(2.5)

8.2***

(2.9)

 

 - Coefficient on mediator (B4)

1.4

(1.2)

2.1*

(1.2)

 
  1. 95% confidence intervals in parentheses; percent sign (%) indicates percentage points change; bold font indicates identified mediators
  2. *p < 0.10; **p < 0.05; ***p < 0.01