In 2012, Senegal’s Ministry of Health and Social Action, through the Programme National de Financement Basé sur les Résultats (PNFBR) and with support from the United States Agency for International Development (USAID), began piloting a results-based financing (RBF) program for health in all health centers and health posts in two regions: Kaffrine and Kolda. The RBF program awards payments to providers and facilities based on achievement of pre-determined quantity and quality targets. Quality assessment checklists are used to score facility-based service quality (see box at right). One year into implementation, it became clear that understanding how provider personnel respond to quality incentives was essential to the long-term success of the program. In 2015, USAID’s Translating Research into Action (TRAction) project launched the Black Box Study, implemented by Results for Development (R4D) and the Netherlands Royal Tropical Institute (KIT), to explore this question.