Paying for Performance: Lessons from a Government Funded Results-Based Financing Pilot in Makueni County, Kenya

This presentation will showcase a government led and funded Results Based Financing (RBF) initiative implemented in Makueni County, Kenya, to improve maternal and newborn health outcomes. Developed through a partnership between the Makueni County Department of Health, Jacaranda Health, and ThinkWell, the program linked performance based payments to key maternal and neonatal health indicators across 30 public facilities. The presentation will highlight the co design process, advocacy strategy that secured domestic funding, and early results demonstrating improvements in emergency referrals, blood availability, antenatal care, and maternal death reviews. Unlike donor driven models, this RBF pilot was financed entirely by the county government, illustrating a sustainable approach to strengthening quality of care. The session will share key lessons for implementing results based mechanisms within existing public systems and budgets, and offer a practical model for other counties or countries seeking to drive measurable MNH improvements using domestic resources.