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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