Maternal health services continue to favour the wealthiest in lower and middle income
countries. Debate about the potential of performance-based financing (PBF) to address
these disparities continues. As PBF is adopted by countries, it is critical to understand the
equity effects for maternal services. The aim of this study is to examine the effects of PBF on
equity in maternal health service use when no specific provisions target the poorest in the
population. In Rwanda, PBF was designed to increase health service use, which was …

Maternal and child health services favor the wealthiest in lower and middle income
countries. Debate about the potential of performance-based financing (PBF) to address
these disparities continues. As PBF is adopted by other countries, it is critical to understand
the equity effects for primary health care services. The aim of this dissertation is to evaluate
the effects of PBF on equity in maternal and child health service use when no specific
provisions target the poorest in the population. In Rwanda, PBF was designed to increase …