Starting date

Results-based financing was initiated in Argentina in 2004 as the Nacer Plan. 

Coverage

As of 2015, 16 million people were covered, which is 36% of Argentina’s total population of 44.2 million.

Budget

USD 5 per beneficiary = 80 million per year.

Description

Since 2004, the Plan Nacer, known as the Sumar program since 2012, finances “results-based” capitation payments to provinces. The payments are used to deliver a pre-defined package of maternal and child health services to eligible pregnant women and children aged under 6, who do not have a formal health insurance.

In 2012, the government launched a new program, Programa Sumar, to expand coverage to children aged 6 to 19 and women aged 20 to 64. In mid-2015, the new program extended to uninsured men aged 20 to 64 years.

The program allocates province-level funding on the basis on beneficiary enrolment and provides incentives following a pay-for-performance model based on indicators for the utilisation and quality of maternal and child health (MCH) services, and health outcomes. The provinces use these resources to pay health facilities for MCH services provided to beneficiaries.

The first impact evaluation found that the program increased the number of perinatal care visits as well as the probability of receiving a tetanus vaccine. The beneficiaries had a 19% lower probability of low birth-weight compared to non-beneficiaries. In addition, the beneficiaries had a 74% lower chance of in-hospital neonatal mortality in larger facilities. Results also showed that the financial autonomy provided to facilities by Plan Nacer allowed a better allocation of scare resources, which led to positive impact on health outcomes of beneficiaries.