The goal was to see whether linkingbonus payments to performance had a positive effect. Rwanda,which was forced to rebuild its institutions after the 1994civil war and genocide, began piloting programs in 2001 togive health clinics cash bonuses for meeting certainhealthcare objectives, such as immunizing children, and forencouraging people to utilize medical services, such ashaving pregnant women deliver in a medical facility.Rwanda's health outcomes in the areas of mother-childhealthcare ranked among the worst for countries in easternand southern Africa and the pro programs were an attempt toensure that people, especially women and children, could getthe care they needed to stay healthy.