The evidence is concentrated in two types of PMM strategies : implementation strategies ( in-service training , continuing education , supervision ) and performance-based financing .
Major gaps exist in accountability arrangements particularly the use of audit and feedback .
The least studied types of outcomes were unintended effects , harm and social equity .
Conclusions The evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes .
The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects .
Introduction We mapped available evidence on  performance measurement and management ( PMM ) strategies in primary healthcare ( PHC ) systems of low-income and middle-income countries ( LMICs ) .
Widely used , their effectiveness remains inconclusive .
This evidence gap map characterises existing research and evidence gaps .
Improving quality and efficiency of facility-based child health care through Integrated Management of Childhood Illness in Tanzania.
OBJECTIVES To assess the effect of Integrated Management of Childhood Illness ( IMCI ) relative to routine care on the quality and efficiency of providing care for sick children in first-level health facilities in Tanzania , and to disseminate the results for use in health sector decision-making . DESIGN Non-r and omized controlled trial to compare child health care quality and economic costs in two intervention ( > 90 % of health care workers trained in IMCI ) and two comparison districts in rural Tanzania . PARTICIPANTS For quality measures , all sick children presenting for care at r and om sample s of first-level health facilities ; for costs , all national , district , facility and household costs associated with child health care , taking a societal perspective . RESULTS IMCI training is associated with significantly better child health care in facilities at no additional cost to districts . The cost per child visit managed correctly was lower in IMCI than in routine care setting s : $ 4.02 versus $ 25.70 , respectively , in 1999 US dollars and after st and ardization for variations in population size . CONCLUSION IMCI improved the quality and efficiency of child health care relative to routine child health care in the study districts . Previous study results indicated that the introduction of IMCI in these Tanzanian districts was associated with mortality levels that were 13 % lower than in comparison districts . We can therefore conclude that IMCI is also more cost-effective than routine care for improving child health outcomes . The dissemination strategy for these results led to adoption of IMCI for nationwide implementation within 12 months of study completion
The evidence is concentrated in two types of PMM strategies : implementation strategies ( in-service training , continuing education , supervision ) and performance-based financing .
Major gaps exist in accountability arrangements particularly the use of audit and feedback .
The least studied types of outcomes were unintended effects , harm and social equity .
Conclusions The evidence is clustered around interventions that are unlikely to achieve transformational change in health outcomes .
The gaps identified suggest that routinely used PMM strategies are implemented without sufficient knowledge of their effects .
Introduction We mapped available evidence on  performance measurement and management ( PMM ) strategies in primary healthcare ( PHC ) systems of low-income and middle-income countries ( LMICs ) .
Widely used , their effectiveness remains inconclusive .
This evidence gap map characterises existing research and evidence gaps .