Annual Results and Impact Evaluation Workshop for RBF - Day Eight - Impact Evaluation Note - Lesotho
Annual Results and Impact Evaluation Workshop for RBF - Day Eight - Impact Evaluation Note -...
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Transcript of Annual Results and Impact Evaluation Workshop for RBF - Day Eight - Impact Evaluation Note -...
Impact Evaluation Note Tajikistan S. Sahibova, S. Barfieva, W. Msisha
H E A LT H R E S U LT S I N N O VAT I O N T R U S T F U N D
1. Background
• Maternal and Child Health (MCH) outcomes in Tajikistan are poor o Infant Mortality Rate: 34 per 1,000 o Under 5 Mortality Rate: 43 per 1,000 o Children under 5 who are stunted: 26% [DHS 2012, Report]
• Coverage of key MCH services is low • NCD’s are also a significant cause of morbidity and
mortality • PHC workers are underpaid and low motivation is a concern • PHC facility managers lack management autonomy
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2. Description of Intervention
Performance Based Financing (PBF) o Implementation of PBF in rural health facilities in 8 districts o PBF will cover a basic package of PHC services including MCH
services, treatment for communicable diseases and selected NCD’s
o An additional intervention is Collaborative Quality Improvement, i.e., a facilitated quality improvement approach focused on common provider-identified objectives with performance feedback and competency training for provider quality improvement teams.
o The second additional intervention is Citizen Report Cards, i.e., the dissemination of information on the performance of local health facilities by distributing a facility report card that benchmarks the performance of local facilities against an appropriately chosen reference.
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3. Primary Research Questions
• What are the effects of PBF on the coverage/ quality of targeted health services?
• What are the incremental effects of CQI and CRC on the coverage/ quality of targeted health services, relative to PBF?
• What is the cost effectiveness of the different interventions?
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4.Outcome Indicators
PHC service coverage indicators for example are: -% of children under 13 months who have received all basic
vaccinations -% of children under five weighed and care-giver provided with
nutrition counseling and education The IE will also measure impact of quality improvement
interventions for example: - PBF quality checklist for facilities - Knowledge of providers - Exit interviews
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6. Identification Strategy/ Method
• The IE will employ both randomization and difference-in-difference approaches to identify the impact of the different combinations of interventions.
• Qualitative methods will also be used
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8. Time Frame / Work Plan
• A baseline survey will be implemented before the end of 2014 during the pre-pilot phase.
• An end-line study will be conducted in 2018 after the interventions have been implemented for approximately 36 months.
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7. Sample and Data
• Sample- 4,554 households in the 6 study groups, and 198 clusters (1 rural health center and its group of health houses)
• Household data • Facility data
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