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This report documents findings from a 15-month pilot study of the effects of financial and non-financial awards on staff motivation and health facility performance. The study was built around clearly documented and shared health facility performance standards that included HMIS indicators, client satisfaction, health center cleanliness, and rational prescription of antibiotics in addition to process standards such as the development of performance plans and definition of clear actions to address problems. It was conducted in two districts in Zambia, one testing out trophies as non-financial incentives and the other providing cash awards for both high performance and improvement. Study results indicate that non-financial awards are more motivating for staff and influential on facility performance than financial awards, in part because they are not nearly as controversial and financial awards.

Published in 2005 under the USAID Quality Assurance project. 

performance-based incentives