Protocol for the evaluation of a quality-based pay for performance scheme in Liberia.

Background: Improving the quality of care at hospitals is a key next step in rebuilding Liberia's health system. In order to improve the efficiency, effectiveness, and quality of care at the secondary hospital level, the country is developing a system to upgrade health worker skills and competencies, and shifting towards improved provider accountability for results, including a Graduate Medical Residency Program (GMRP) and provider accountability for improvements in quality through performance-based financing (PBF) at the hospital level.

Methods/design: This document outlines the protocol for the impact evaluation of the hospital improvement program.