ABSTRACT Objective: Pay for performance (P4P) has been used in a number of health programmes in India, especially in maternal and child health programmes. In this assignment I take a look at the current evidence we have about P4P and compare it with how it is used in India. Method P4P: Search for literature in MEDLINE (ovid) for literature published between January 2000 and November 2014, supplemented by reference tracking. Each articles quality was assessed using a checklist from Nasjonalt kunnskappsenter for helsetjenester 2008 . Method Health Programs in India: Search in nrhm.gov.in (government of India), NORAD, WHO, NIPI.org.in. Search for evaluations in MEDLINE (ovid). Results: I identified 10 reviews about P4P/CCT that met my inclusion criteria. There is evidence showing that P4P can increase the use of health services. The current evidence base is too weak to conclude if P4P can affect maternal or neonatal mortality or quality of care. We know little about the cost-effectiveness of P4P or the best design. In India it has been an increase in facility birth through the P4P programmes. The programs have not shown a significant decrease in maternal mortality or in neonatal mortality. There have been reports about negative effects like increased fertility and corruption, but this has to be investigated further. Conclusion: P4P in India has increased births in facility, but it has not given a decrease in maternal or neonatal death. I think the focus should now be to increase the quality of care and the programmes should be modified so that it is more suitable for decreasing maternal and neonatal death.