Open Access Research article

Exploring the potential for using results-based financing to address non-communicable diseases in low- and middle-income countries

Chelsey R Beane*, Suzanne Havala Hobbs and Harsha Thirumurthy

Author Affiliations

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box 7411, 135 Dauer Drive, Chapel Hill, NC, 27599, USA

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BMC Public Health 2013, 13:92  doi:10.1186/1471-2458-13-92

Published: 1 February 2013



The burden of disease due to non-communicable diseases (NCDs) is rising in low- and middle-income countries (LMICs) and funding for global health is increasingly limited. As a large contributor of development assistance for health, the US government has the potential to influence overall trends in NCDs. Results-based financing (RBF) has been proposed as a strategy to increase aid effectiveness and efficiency through incentives for positive performance and results in health programs, but its potential for addressing NCDs has not been explored.


Qualitative methods including literature review and key informant interviews were used to identify promising RBF mechanisms for addressing NCDs in resource-limited settings. Eight key informants identified by area of expertise participated in semi-structured interviews.


The majority of RBF schemes to date have been applied to maternal and child health. Evidence from existing RBF programs suggests that RBF principles can be applied to health programs for NCDs. Several options were identified for US involvement with RBF for NCDs.


There is potential for the US to have a significant impact on NCDs in LMICs through a comprehensive RBF strategy for global health. RBF mechanisms should be tested for use in NCD programs through pilot programs incorporating robust impact evaluations.

Non-communicable diseases; Results-based financing; Pay-for-performance; Performance incentives; Health aid