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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