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Table 7 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—public health facilities only (% change) Taken at least 2 doses of anti-malaria drug (% change)
Effect of P4P without mediators 7.9*** 7.4** 11.2***
  (2.4; 13.3) (0.9; 13.9) (3.9, 18.5)
Effect of P4P mediated by
Health worker received supervision in last 90 days
- Coefficient on P4P (B1) 3.7 0.3 12.8***
  (−3.1; 10.4) (−7.4; 8.1) (4.5; 21.2)
- Coefficient on mediator (B4) 0.3 -2.7 8.7*
  (-6.9; 7.6) (-11.0; 5.6) (-0.2; 17.6)
Governing committee met in the past 90 days
- Coefficient on P4P (B1) 8.0*** 5.7* 11.8***
  (2.2; 13.8) (−0.9; 12.3) (3.9; 19.8)
- Coefficient on mediator (B4) 1.8 −1.4 1.0
  (−2.9; 6.5) (−6.7; 4.0) (−5.5; 7.4)
Drugs at delivery-stock-out index (0–1 index)
- Coefficient on P4P (B1) 7.1** 3.0 11.5***
  (1.4; 12.9) (−3.5; 9.5) (3.6; 19.4)
- Coefficient on mediator (B4) −4.2* −5.5* −1.2
(−9.2; 0.7) (−11.0; 0.1) (−8.0; 5.5)
Oxytocin injection stock-out last 90 days
- Coefficient on P4P (B 1 ) 5.8** 1.9 12.3***
  (0.2; 11.5) (−4.5; 8.3) (4.3; 20.3)
- Coefficient on mediator (B 4 ) −6.3*** −6.9*** 0.4
  (−10.3; 2.3) (−11.5;−2.3) (−5.2; 6.1)
Ergometrin injection stock-out last 90 days
- Coefficient on P4P (B1) 8.3*** 4.5 11.9***
  (2.3; 14.3) (−2.2; 11.2) (3.8; 20.0)
- Coefficient on mediator (B4) 0.6 0.2 −0.9
  (-3.2; 4.5) (-4.2; 4.5) (-6.1; 4.3)
Antimalarials stock-out last 90 days
- Coefficient on P4P (B1) 7.9*** 5.7* 13.0***
  (2.9) (3.4) (3.9)
- Coefficient on mediator (B4) −2.4 −5.2* 2.5
  (2.6) (3.0) (3.5)
Service delivery disrupted due to broken equipment last 90 days
- Coefficient on P4P (B1) 7.7*** 3.9 11.4***
  (2.0; 13.3) (−2.5; 10.3) (3.7; 19.2)
- Coefficient on mediator (B4) −5.0* −5.3 −1.5
  (−10.6; 0.7) (−11.7; 1.1) (−9.2; 6.3)
Health worker knowledge
- Coefficient on P4P (B1) 7.6** 4.3 10.1**
  (1.3; 13.9) (−2.7; 11.3) (1.7; 18.5)
- Coefficient on mediator (B4) −7.2 −3.2 0.5
(−17.9; 3.5) (−15.2; 8.8) (−13.8; 14.8)
Health worker kindness
- Coefficient on P4P (B1) 7.8*** 5.2 11.6***
  (2.2; 13.3) (−1.1; 11.4) (4.1; 19.0)
- Coefficient on mediator (B4) 0.3 −0.3 −0.11
  (−1.4; 2.0) (−0.23; 0.16) (−0.34; 0.12)
Proportion of women who paid for delivery in a HF
- Coefficient on P4P (B1) 8.2*** 3.0 9.9**
  (2.5; 13.8) (−3.2; 9.1) (2.4; 17.5)
- Coefficient on mediator (B4) 3.8 −27.7*** −16.6
  (−12.6; 20.2) (−2.4; 1.7) (−38.5; 5.2)
  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