Pay for performance: an analysis of the context of implementation in a pilot project in Tanzania.

Background: Pay for performance schemes are increasingly being implemented in low income countries to improve health service coverage and quality. This paper describes the context within which a pay for performance programme was introduced in Tanzania and discusses the potential for pay for performance to address health system constraints to meeting targets.

Method: 40 in-depth interviews and four focus group discussions were undertaken with health workers, and regional, district and facility managers.

A health system in economic crises: a case study from Iceland.

Background: There has been a lack of systematic inquiry into how governments respond during times of crises, how well these responses comply with good governance, and how they affect health systems. The aim of this study was to analyse the reactions of the Icelandic health system during the first 7 months of the economic crisis in 2008.

Methods: The grounded theory approach was used in data sampling, collection, and data analysis.

The fallacy of the equity-efficiency trade off: rethinking the efficient health system.

In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency.