Health Results-Based Financing Impact Evaluation 2014, Health Facility Baseline Survey
Nigeria, 2014
Identification
NGA_2014_HRBFIE-BL_v02_M
Health Results-Based Financing Impact Evaluation 2014
Health Facility Baseline Survey
| Name | Country code |
|---|---|
| Nigeria | NGA |
Results-based financing (RBF) in the health sector has been defined as a financing mechanism where cash or non-monetary transfers are made to a national or sub-national government, manager, provider, payer or consumer of health services after predefined service delivery or health outcomes results have been attained and verified.
An increasing number of countries are implementing RBF approaches as an alternative to input-based financing, and many of these countries have been employing a performance-based financing approach, a particular type of RBF in which health facilities are rewarded monetarily for producing predefined results in terms of quantity and quality of agreed services, subject to verification of those outputs by an independent party.
The Health Results Innovation Trust Fund (HRITF) was created in 2007 to support results-based financing approaches in the health sector. Through RBF, the HRITF aims to improve maternal and child health around the world. HRITF is supported by the Governments of Norway through Norad and the United Kingdom through the Department for International Development (DFID). It is administered by the World Bank.
To date, HRITF has committed $396 million for 36 RBF programs in 30 countries, linked to $2.2 billion in financing from IDA—the World Bank’s fund for the poorest.
The objective of this impact evaluation is to assess in a rigorous way the impact of the health and nutrition result-based financing (RBF) approach on service utilization and health and nutrition outcomes Nigeria, introduced as part of the Maternal and Child Nutrition and Health Results Project.
The World Bank and the government of Nigeria prepared a results-based financing (RBF) project which provides incentives for improving performance at critical levels within the Nigerian health system. This RBF project called the Nigeria State Health Investment Project (NSHIP), aims to increase the delivery and utilization of maternal and child health services, reproductive, and disease-control health services, with a specific focus on the poor. NSHIP also looks to improve quality of care provided, particularly in publicly financed health facilities.
A key feature of this RBF project is the provision of financial incentives to States and Local Government Agencies based on results achieved. Project interventions will benefit the entire populations of the states of Adamawa, Nasarawa, and Ondo, about 9.4 million people in total.
The primary goal of the impact evaluation is to determine if providing financial incentives linked directly to performance increases the quantity and quality of maternal and child health services.
The impact evaluation attempts to equalize as much as possible the average amount of funding between health facilities that received results-based financing, and their comparisons, by using as comparisons a set of facilities that received decentralized facility financing (DFF), a type of block grant that compensate the income effect for the comparison facilities that do not receive the RBF program. Researchers randomized Local Government Agencies to DFF or RBF to evaluate the conditionality.
The RBF and DFF pilots will be implemented for approximately 2.5 years (about 30 months) before endline data collection for the impact evaluation begins.
The baseline survey, conducted in 2014, included a health facility survey and a household survey. Baseline health facilities data is documented here.
Sample survey data [ssd]
- public health facility
Version
v01, edited, anonymized datasets for public distribution
Scope
The scope of the study includes:
- Health facility:
- General information
- Universal precautions
- Administration and management
- Services: Vaccination, Antenatal care, Delivery and postpartum, Tuberculosis, HIV, Inpatient, other
- User fees
- Leadership
- Autonomy
- Catchment area
- Human resources
- Laboratory (tests, equipment)
- Drug and vaccine storage and availability
- General Health Management Information Systems (HMIS)
- Direct observation
-
Patient tracking
-
Direct observations for antenatal care visit, and patient exit interview
-
Direct observations for children under 5, and patient exit interview
-
Health provider:
- Health services provided
- On job training
- Hours and duties
- Salary, other compensation, supplemental income
- Supervision
- WHO well-being index
- Job satisfaction
- Personal drive
- Innovation
- Staff knowledge
Coverage
Nasarawa, Adamawa and Ondo states
Producers and sponsors
| Name |
|---|
| Federal Ministry of Health, Nigeria |
| National Bureau of Statistics, Nigeria |
| World Bank |
| Name |
|---|
| Government of Nigeria |
| Health Results Innovation Trust Fund |
Sampling
The sample frame for the health facility surveys comprised of all functioning model health facilities in each selected LGA. The frame excluded all private health facilities as well as other secondary and tertiary public facilities.
The health facility survey included approximately 1,115 health centers in 3 states.
- 830 model primary health care centers
- 85 general/cottage hospitals
- 200 public health care centers (non-RBF/DFF) but in the same wards as the RBF/DFF health facilities.
The number of health workers to be interviewed would be 3 per facility. For each of the health workers, there would also be 3 direct observations and 3 exit interviews. Timewise, the direct observations and exit interviews need to be done BEFORE the health worker interview in a particular facility.
Hospitals were included in the health facility survey using an adapted health facility instrument. The adapted instrument would focus on maternal and child health service delivery and would not include other categories of services. The expected number of hospitals to be surveys is 12 in Nasarawa, 17 in Ondo and 20 in Adamawa.
Survey instrument
-
HF1 - Health Facility Assessment
-
HF2 - Patient Tracking Form
-
HF3 - Direct Observations for Antenatal Care Visit
-
HF4 - Direct Observations for Children Under 5
-
HF5 - Exit Interview for Antenatal Care Visit
-
HF6 - Exit Interview for Children Under 5
-
HF7 - Health Provider Survey: Individual Interview
Data collection
| Start | End |
|---|---|
| 2014-08-25 | 2014-09-30 |
Depositor information
| Name | Affiliation |
|---|---|
| Opeyemi Abiola Fadeyibi | World Bank |
Data Access
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
Federal Ministry of Health, Nigeria, National Bureau of Statistics, Nigeria, World Bank. Nigeria Health Results-Based Financing Impact Evaluation 2014, Health Facility Baseline Survey. Ref. NGA_2014_HRBFIE-BL_v02_M. Dataset downloaded from [URL] on [date].
Disclaimer and copyrights
This material was produced with support from the World Bank. The findings, interpretation, and conclusions expressed herein are those of the authors and do not necessarily reflect the views of the Board of Executive Directors of the World Bank or the governments they represent.
Contacts
| Name | Affiliation | |
|---|---|---|
| Ayodeji Oluwole Odutolu | World Bank | aodutolu@worldbank.org |
Metadata production
DDI_NGA_2014_HRBFIE-BL_v02_M_WB
| Name | Affiliation | Role |
|---|---|---|
| Development Data Group | World Bank | Study documentation |
2016-08-18
Metadata version
v01 (August 2016)