Using Results-based Funding to Drive Health Equity

A new report from ACTION and Social Finance, a UK-based nonprofit, presents results-based funding (RBF) as an important tool for development funders to consider adopting in order to create equitable health systems. RBF is a relatively new approach to development funding, but it has been widely tested in global health, with overall positive results. The funder transfers funds in exchange for specific results agreed to by both parties. When implemented well, RBF can increase the results focus, rigor, and recipient autonomy and flexibility of development programs.

Evidence shows that RBF has helped to improve equity; however, further research is needed to determine to what extent RBF can be a driver for equity. Allowing program implementers the flexibility to adapt and tweak their approach to respond to changing needs is also important.

The report issues six recommendations for policymakers who want to use RBF to promote equity. The following features are critical to program design:

  1. Target poor/disadvantaged populations
  2. Focus on outcomes
  3. Reward progress, not just absolute success
  4. Engage governments to identify priorities that fit within health plans
  5. Independently verify outcomes to ensure credibility
  6. Allow implementers flexibility to deliver interventions