1) Results-based financing was introduced in Afghanistan's health system in 2010 to improve poor health indicators by paying health facilities for additional and higher quality services, especially for the poor. 2) An impact evaluation found that key indicators like antenatal care, postnatal care, and skilled birth attendance increased significantly more in facilities using results-based financing compared to similar control facilities. 3) The longer results-based financing was in place, the greater the improvements in health services. Quality of care also improved in hospitals using results-based financing approaches.