Contracting out government health services has been increasing in low and middle income countries (LMICs) and highly valued in improving health service delivery. In some cases, government health workers have been paid performance-based payments; such payments have been quoted to contribute to the achievement. However, impacts of the payments on the health workers’ total income including income from their private practice and the government salaries have been little studied, while their private practice have posed serious issues in the service delivery with the constraint from low government salaries. The impacts at the household level have been unstudied