Health Results Based Financing Impact Evaluation 2015
Lesotho, 2015
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LSO_2015_HRBFIE-FBL_v01_M
Health Results Based Financing Impact Evaluation 2015
Health Facility Baseline Survey
| Name | Country code |
|---|---|
| Lesotho | LSO |
Impact Evaluation Survey
The Health Results Innovation Trust Fund (HRITF) launched in 2007. It supports results-based financing (RBF) approaches in the health sector to improve maternal and child health around the world. The 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.
As of September 2016, the total contributions to the trust fund were US$477.6 million equivalent from Norway and the United Kingdom. To date, HRITF has committed US$385.6 million for 35 RBF programs in <a href="http://www.rbfhealth.org//projects">29 countries</a>, linked to US$2.0 billion in financing from IDA—the World Bank’s fund for the poorest. In addition to the RBF programs, the trust fund also finances the evaluation of these programs and other supporting activities. Funded by the HRITF, the Lesotho Health Results Based Financing Impact Evaluation Baseline Survey was conducted in 2015.
To learn more, visit the <a href=" https://www.rbfhealth.org"> RBF Health website</a>, explore <a href="http://www.rbfhealth.org/projects">RBF Projects</a> around the world, or read the most recent <a href="http://www.rbfhealth.org/publication/achieving-results-women%E2%80%99s-and-childrens-health-2015-progress-report">progress report </a>
The Lesotho Health Results Based Financing Impact Evaluation Baseline Survey was conducted in four districts: Mafeteng, Mohale’s Hoek, Mokhotlong and Thaba-Tseka of Lesotho, between March and June 2015. The pilot survey collected data from two districts (Leribe and Quthing) before scaling up to the four aforementioned districts.
The objective of the survey was to measure outcomes prior to the implementation of the Health Performance-Based Financing (PBF) intervention. Data was collected in the four districts through household surveys and facility assessments of health centers. The survey is largely based on the Health Results Innovation Trust Fund (HRITF) instruments that were modified to the Lesotho and project context.
The baseline survey consists of two main sources of data: 1) a household survey and 2) a health facility-based survey.
- The primary goal of the household survey is to measure health service coverage at the population level as well as select health outcome indicators measured through anthropometry or tests. The survey also collects broader data on the health of the households, health seeking behaviors and barriers to use of health services.
- The goal of the facility-based survey is to measure multiple dimensions of quality of care and collect detailed information on key aspects of facility functioning. It includes multiple components; a facility assessment, health provider interviews, and patient exit interviews, and it is documented here.
Sample survey data [ssd]
Scope
The main themes covered by the facility assessment include:
• Facility staffing, including the staffing complement of the facility, staff on duty at the time of the survey team’s visit and staff present at the time of the survey team’s visit
• Facility infrastructure and equipment
• Availability of drugs, consumables and supplies at the health center
• Supervision
• Record keeping and reporting to the Health Management Information System (HMIS)
• Facility management
The main themes covered by the health worker interview module include:
• Role and responsibilities of the interviewed health worker
• Staff satisfaction and motivation
• Technical knowledge on Maternal and Newborn Health. This was assessed through the use of vignettes.
Patient exit interviews recorded patient experience; patient’s perception of quality of care and satisfaction at all health centers.
Coverage
The baseline survey covers four districts: Mafeteng, Mohale’s Hoek, Mokhotlong and Thaba-Tseka.
District
The Performance Based Financing Project (PBF) is implemented in health centers managed by the Ministry of Health (MOH) and Christian Health Association of Lesotho (CHAL).
Producers and sponsors
| Name | Affiliation |
|---|---|
| Gil Shapira | DECHD, World Bank |
| Damien de Walque | DECHD, World Bank |
| Name |
|---|
| Health Results Innovation Trust Fund, World Bank |
Sampling
The facility survey was conducted in all Ministry of Health (MOH) and Christian Health Association of Lesotho (CHAL) health centers in the four districts, except for three randomly excluded health centers and one health center that was not accessible for the survey team.
The facility-based survey includes multiple components; a facility assessment, health provider interviews, and patient exit interviews.
- Facility assessment module: The respondent for this module was the individual in charge of the health facility at the time when the survey team visited the health center.
- Health worker interview module: A sample of up to three health providers with maternal and newborn health service delivery responsibilities at health facilities were interviewed as part of this module. Eligible health workers include doctors, nurses, midwifes, and any other health worker providing maternal and newborn care. However, no doctors were available for interview in the health centers. In facilities with less than three health workers on the staff roster, all eligible health workers were interviewed.
- Patient exit interviews : A sample of two caregivers of children less than five visiting the facility for curative care with (preferably) a new complaint were interviewed to record the patient’s experience and assess the patient’s perception of quality of care and satisfaction at all health centers. In addition to this, exit interviews were conducted with two (preferably) first time ANC clients.
The final sample includes 53 health centers, 107 health provider interviews, 106 exit interviews with women who visited the health center for ANC, and 105 exit interviews with caregivers of children less than five who visited the health center at the day of the survey.
Three health centers were randomly excluded and one health center was not accessible for the survey team.
No doctors were available for interview in the health centers
Survey instrument
- The facility assessment module: This module collects data on key aspects of facility functioning and structural aspects of quality of care. The respondent for this module was the individual in charge of the health facility at the time when the survey team visited the health center.
- The health worker interview module: A sample of up to three health providers with maternal and newborn health service delivery responsibilities at health facilities were interviewed as part of this module.
- Patient exit interviews: A sample of two caregivers of children less than five visiting the facility for curative care with (preferably) a new complaint were interviewed to record the patient’s experience and assess the patient’s perception of quality of care and satisfaction at all health centers. In addition to this, exit interviews were conducted with two (preferably) first time ANC clients.
Data collection
| Start | End |
|---|---|
| 2015-03 | 2015-06 |
| Name |
|---|
| Leads Services |
Health Facility survey team organization: One field team was trained to conduct the facility survey and the survey was pre-tested before the implementation. The team consisted of two supervisors and two interviewers. The interviewers reported directly to their supervisor, while the supervisors reported directly to the manager.
A local firm, Leads Services, was contracted to implement the baseline survey for the study, for both households and health centers. Leads Services was responsible for all aspects of the baseline survey implementation under the supervision and guidance of the research team. The national Health Institutional Review Board authorized to conduct the survey on February 13th, 2015.
Depositor information
| Name | Affiliation |
|---|---|
| Gil Shapira - DEC Human Development and Public Services | The World Bank Group |
Data Access
| Name | Affiliation | |
|---|---|---|
| Gil Shapira | The World Bank | gshapira@worldbank.org |
- Licensed datasets, accessible under conditions
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:
Shapira, Gil., Damien de Walque. 2015. Lesotho Health Results Based Financing Impact Evaluation 2014 (HRBFIE-FBL), Health Facility Baseline Survey. Ref. LSO_2015_HRBFIE-FBL_v01_M.The World Bank. Dataset downloaded from [URL] on [date].
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | |
|---|---|---|
| Gil Shapira | The World Bank | gshapira@worldbank.org |