I am a researcher at the Institute for Public Health of the University of Heidelberg in Germany and part of an interdisciplinary team of social and medical scientists. Our broader research focus is on health systems strengthening and health care financing. I myself am a clinician by training with many years of experience in both clinical care and public health research in different Sub-Saharan African countries. Our research team has conducted several external evaluations of different PBF programs in Malawi, Burkina Faso, Cameroon, and the Republic of Congo. The main focus of my research is to understand the impact PBF programs on different aspects of quality of care (clinical performance, service readiness, client and provider perception). As a researcher with a clinical background I am interested in the impact performance incentives have on clinical and organizational performance related to facility-based healthcare provision and service quality. My current focus on quality of care assessment is mainly built on identifying structural and process indicators most relevant and most directly linked to mortality reduction in a given target population and their relation to prevailing routines in clinical and organizational performance of health workers and health facilities in low- and middle income countries. I personally consider PBF foremost as a financing mechanism wich the potential to advance strategic purchasing options, especially in health systems where service purchasing is dominated by budget- or other input-based financial arrangements. Being an active purchasing strategy, PBF currently represents an ideal approach to incentivizing high quality service outputs and outcomes, especially in low- and middle-income countries. At the same time, PBF also provides an open floor for an interdisciplinary approach towards understanding and discussing those aspects most relevant to quality improvement in health service provision.