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Equity theory explains how our sense of fairness influences the dynamics of close relationships. Rooted in social psychology, the theory posits that individuals evaluate fairness by comparing the ratio of their contributions to the rewards they receive. Relationship satisfaction is highest when these ratios are perceived as balanced between partners, promoting mutual reciprocity and a sense of justice.Equity vs. Equality in RelationshipsEquity is distinct from equality. Fairness does not...
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The Joint Effect of Social Comparison and Social Distance on Evaluation of Intertemporal Choice Outcomes in Event-related Potential Studies
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What theories underpin performance-based financing? A scoping review.

Elisabeth Paul1, Oriane Bodson2, Valéry Ridde3

  • 1School of Public Health, Universite Libre de Bruxelles, Brussels, Belgium.

Journal of Health Organization and Management
|January 19, 2021
PubMed
Summary

Performance-based financing (PBF) in low- and middle-income countries lacks a strong theoretical foundation. This review found inconsistent and often inappropriate application of theories, highlighting a need for further exploration of PBF justifications.

Keywords:
Low- and middle-income countriesPerformance-based financingScoping reviewTheory

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Area of Science:

  • Health economics
  • Health systems research
  • Policy analysis

Background:

  • Performance-based financing (PBF) is a common strategy for health system reform in low- and middle-income countries (LMICs).
  • The theoretical underpinnings of PBF in these contexts are not well-established.
  • Understanding these theoretical bases is crucial for effective policy design and implementation.

Purpose of the Study:

  • To explore the theoretical foundations that justify the use of PBF in the health sector of LMICs.
  • To identify and analyze the theories underpinning PBF and their justifications.

Main Methods:

  • A scoping review of the literature on PBF was conducted.
  • Studies were analyzed to identify theories used to support PBF and their justifications.
  • Sixty-four studies met the inclusion criteria for the review.

Main Results:

  • Economic theories, particularly principal-agent theory, were predominant but often inappropriately applied.
  • Psychological motivation theories and other social sciences also contributed, but with contradictions.
  • No single theory provided a comprehensive, consistent, or credible justification for PBF in LMICs.

Conclusions:

  • The theoretical justifications for PBF in LMICs are significantly under-documented.
  • Existing theoretical applications are inconsistent and may even argue against PBF adoption.
  • Further research and debate are needed to establish robust theoretical support for PBF.