Table 1 Effects of the PBF program on outcomes at the health facility level

Panel a: structural quality

 Basic equipment index

0.54

0.04 (0–0.07)

7%

290

0.75

0.01 (− 0.03 to 0.05)

1%

56

 Essential medicine and consumables index

0.68

0.01 (− 0.04 to 0.07)

2%

290

0.85

 − 0.04 (− 0.11 to 0.03)

 − 5%

56

 Vaccines index

0.62

0.05 (− 0.08 to 0.17)

8%

275

0.13

 − 0.06 (− 0.2 to 0.09)

 − 47%

53

 Family planning products index

0.35

0.19 (0.11–0.27)

55%

290

0.53

0 (− 0.12 to 0.12)

 − 1%

56

 Infrastructure index

0.36

0.02 (− 0.03 to 0.07)

6%

290

0.65

0.04 (− 0.05 to 0.14)

7%

56

 Infection prevention and control index

0.45

0.04 (− 0.03 to 0.11)

9%

264

0.75

0.01 (− 0.11 to 0.13)

2%

55

 Average impact^a

0.50

0.05 (0.01–0.09)

10%

0.72

0 (− 0.03 to 0.03)

0%

Panel b: technical process quality

 Antenatal care score

0.91

0.02 (− 0.03 to 0.08)

3%

1482

0.87

0.06 (0–0.13)

7%

283

 IMCI: assessment score

0.56

0.03 (− 0.01 to 0.08)

6%

1631

0.65

0.05 (− 0.01 to 0.1)

7%

364

 IMCI: diagnosis score

0.68

0.05 (− 0.02 to 0.12)

7%

1240

0.59

0.12 (− 0.04 to 0.28)

21%

272

 IMCI: correct treatment

0.64

0.06 (− 0.04 to 0.16)

9%

1304

0.64

 − 0.06 (− 0.17 to 0.06)

 − 9%

294

 IMCI: no unnecessary treatment

0.60

0.07 (− 0.05 to 0.19)

11%

422

0.52

 − 0.04 (− 0.31 to 0.22)

 − 8%

74

 Family planning consultation score

0.67

0.15 (0.06–0.23)

16%

575

0.89

0.06 (− 0.04 to 0.16)

7%

159

 Delivery score

0.60

0.03 (− 0.04 to 0.1)

5%

259

0.67

0.07 (− 0.01 to 0.15)

10%

135

 Postpartum care score

0.07

0.03 (− 0.05 to 0.12)

45%

278

0.02

0.17 (0.02–0.31)

1063%

141

 Newborn care score

0.74

0.04 (− 0.08 to 0.16)

6%

279

0.76

0.11 (− 0.01 to 0.22)

14%

143

 Average impact^a

0.55

0.04 (0.02–0.07)

7%

0.62

0.06 (0.03–0.09)

10%

Panel c: non-technical process quality

 Antenatal care respect index

0.80

 − 0.03 (− 0.1 to 0.03)

 − 4%

1489

0.81

0.03 (− 0.1 to 0.15)

3%

283

 Antenatal care user satisfaction

0.91

0.01 (− 0.02 to 0.04)

1%

1475

0.87

 − 0.01 (− 0.09 to 0.07)

 − 1%

281

 Child curative care respect index

0.75

0.01 (− 0.07 to 0.1)

2%

1631

0.76

0.08 (− 0.01 to 0.17)

10%

364

 Child curative care user satisfaction

0.88

0 (− 0.04 to 0.04)

0%

1610

0.83

0.01 (− 0.07 to 0.09)

1%

362

 Family planning consultation respect index

0.82

0.09 (0.03–0.16)

12%

575

0.81

0.05 (− 0.06 to 0.16)

6%

159

 Family planning consultation user satisfaction

0.91

0.01 (− 0.04 to 0.06)

1%

563

0.89

0.01 (− 0.06 to 0.07)

1%

155

 Delivery care respect index

0.96

0.04 (0–0.08)

4%

294

0.95

0.01 (− 0.05 to 0.06)

1%

148

 Average impact^a

0.88

0.02 (− 0.01 to 0.04)

2%

0.88

0.02 (− 0.01 to 0.05)

2%

Panel d: service fees (in Congolese Francs)

 ANC fee reported by facility

2493

 − 720 (− 1270 to − 170)

 − 29%

289

2540

425 (− 1402 to 2252)

17%

54

 Delivery fee reported by facility

8734

 − 1733 (− 3606 to 141)

 − 20%

288

11,788

 − 1959 (− 5764 to 1847)

 − 17%

56

 Family planning consultation fee reported by facility

574

 − 198 (− 524 to 128)

 − 34%

228

1000

 − 545 (− 1472 to 382)

 − 54%

52

 Curative care fee reported by facility (not specific for child care)

3120

638 (− 37 to 1313)

20%

244

4438

 − 567 (− 4104 to 2970)

 − 13%

16

 ANC fees reported in exit interviews

1976

149 (− 660 to 958)

8%

1489

3221

1098 (− 944 to 3139)

34%

283

 Child curative care fees reported in exit interviews

4997

 − 1006 (− 1897 to − 116)

 − 20%

1631

13,917

 − 1238 (− 4460 to 1984)

 − 9%

364

 Family planning consultation fee reported in exit interviews

704

 − 30 (− 608 to 548)

 − 4%

577

1980

 − 819 (− 2531 to 892)

 − 41%

159

 Average impact^a

2,355

 − 248 (− 657 to 162)

 − 11%

2,574

 − 330 (− 973 to 314)

 − 13%

Panel e: fee policies and user satisfaction with fees

 Flat fees

0.51

0.22 (0.08–0.36)

43%

290

0.58

0.14 (− 0.13 to 0.4)

24%

56

 Fees posted

0.63

0.17 (0.06–0.28)

27%

290

0.69

0.29 (0.09–0.48)

41%

56

 Fee exemptions for poor users

0.67

0.19 (0.1–0.29)

29%

287

0.77

0.05 (− 0.16 to 0.27)

7%

56

 Satisfaction with service affordability in antenatal care exit interviews

0.91

0.11 (0.01–0.2)

12%

1266

0.87

0.17 (0.05–0.3)

20%

259

 Satisfaction with service affordability in child care exit interviews

0.88

0.03 (− 0.03 to 0.08)

3%

1560

0.83

0.03 (− 0.15 to 0.2)

3%

359

 Satisfaction with service affordability in family planning exit interviews

0.91

0.12 (− 0.05 to 0.29)

13%

245

0.89

0.19 (− 0.05 to 0.44)

22%

88

 Average impact^a

0.70

0.13 (0.06–0.20)

18%

0.67

0.15 (0.08–0.23)

22%

Panel f: facility management

 Protocols index

0.43

0.11 (0.03–0.19)

25%

290

0.66

0.08 (− 0.02 to 0.19)

13%

56

 Reporting index

0.76

0.06 (0–0.12)

8%

197

0.93

0.04 (− 0.03 to 0.11)

4%

39

 Posting of infection and control procedures index

0.25

0.19 (0.06–0.32)

76%

264

0.54

0.26 (0.07–0.45)

48%

55

 Mechanism to Seek patients’ opinions

0.60

0.07 (− 0.07 to 0.21)

12%

290

0.54

0.22 (− 0.02 to 0.46)

41%

56

 Average impact^a

0.57

0.09 (0.04–0.15)

16%

0.73

0.11 (0.02–0.21)

15%

Panel g: providers’ satisfaction

 Satisfied with information on own performance

0.77

0.02 (− 0.06 to 0.1)

3%

1129

0.64

0.09 (− 0.07 to 0.25)

14%

275

 Satisfied with level of autonomy

0.79

 − 0.05 (− 0.12 to 0.02)

 − 6%

1146

0.74

0 (− 0.12 to 0.12)

0%

278

 Satisfied with the relationship with the local facility committee

0.74

0.01 (− 0.05 to 0.07)

1%

1019

0.66

0.08 (− 0.04 to 0.21)

13%

225

 Satisfied with support from supervisor

0.75

0.03 (− 0.03 to 0.1)

4%

1153

0.71

0.09 (− 0.04 to 0.22)

12%

274

 Satisfied with recognition received from supervisor

0.79

0.02 (− 0.04 to 0.07)

2%

1163

0.77

0.05 (− 0.04 to 0.14)

6%

277

 Satisfied with reward received from work

0.51

0.02 (− 0.07 to 0.1)

3%

1068

0.43

0.1 (− 0.07 to 0.28)

24%

250

 Satisfied with ability to use skills

0.75

 − 0.03 (− 0.09 to 0.03)

 − 4%

1147

0.69

0.05 (− 0.08 to 0.18)

8%

275

 Satisfied with training opportunities

0.56

 − 0.01 (− 0.11 to 0.08)

 − 2%

1003

0.64

 − 0.04 (− 0.19 to 0.1)

 − 7%

251

 Satisfied with security at the facility

0.86

0.02 (− 0.04 to 0.08)

3%

1080

0.81

0.02 (− 0.08 to 0.11)

2%

265

 Satisfied with work conditions

0.55

 − 0.03 (− 0.12 to 0.06)

 − 5%

1169

0.45

0.03 (− 0.12 to 0.17)

6%

278

 Satisfied with leave

0.66

 − 0.04 (− 0.12 to 0.05)

 − 5%

1015

0.79

 − 0.07 (− 0.17 to 0.02)

 − 9%

267

 Satisfied with work hours

0.72

0.02 (− 0.08 to 0.11)

2%

1166

0.70

0 (− 0.12 to 0.12)

0%

279

 Satisfied with teamwork

0.92

 − 0.01 (− 0.05 to 0.03)

 − 1%

1172

0.89

0.02 (− 0.06 to 0.09)

2%

276

 Satisfied with relationship with facility management

0.86

 − 0.03 (− 0.09 to 0.02)

 − 4%

1138

0.87

 − 0.01 (− 0.09 to 0.06)

 − 2%

263

 Satisfied with income overall

0.26

0 (− 0.09 to 0.1)

0%

1136

0.19

0.04 (− 0.09 to 0.17)

22%

271

 Satisfied with potential for promotion

0.57

0 (− 0.09 to 0.09)

0%

1066

0.57

0.04 (− 0.09 to 0.18)

7%

256

 Average impact^a

0.75

0 (− 0.02 to 0.01)

0%

0.72

0.02 (− 0.01 to 0.05)

3%