Health Results-Based Financing Impact Evaluation 2013
Burkina Faso, 2013 - 2014
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BFA_2013_HRBFIE-FBL_v01_M
Health Results-Based Financing Impact Evaluation 2013
Health Facility Baseline Survey
| Name | Country code |
|---|---|
| Burkina Faso | BFA |
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.
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 baseline survey on impact evaluation for Health Performance-Based Financing (PBF) in Burkina Faso was conducted in six regions of Burkina Faso from October 2013 to March 2014.
The main objective of the impact evaluation is to assess the impact of the PBF intervention on quality of care and health care utilization for Maternal, Newborn and Child Health services, while the baseline survey provides the empirical foundation for the assessment of impacts on a large variety of indicators. The endline wave of the impact evaluation is planned from March - June 2017.
The impact evaluation innovates by assessing the combination of PBF, community-based targeting of poor and subsidization of health services provided to the poor/vulnerable peoples and community-based health insurance. PBF is implemented at the district level (combining primary and secondary health) - with control districts in the same regions and the demand-side interventions are randomized at the health facility level.
The study adopts a blended experimental and quasi-experimental design, including both randomization of additional interventions at the facility-level with PBF districts (experimental) to test the effects of these interventions on outcomes of interest, conditional on PBF, and matching of facilities in neighboring pure control districts (quasi-experimental), to test the effects of these interventions, including PBF, in the absence of any intervention (counterfactual).
Data collection for the baseline survey included a household survey and a facility-based survey. The health facilties survey is documented here.
Sample survey data [ssd]
Health facility
Version
v01, edited anonymous datasets
Scope
The scope of the study includes:
- General characteristics of the facility
- Maternal health: utilization indicators
- Quality of care: maternal and under-five health services
- Child health: utilization indicators
- Nutrition
- Human Resources and Management of Health Care Facilities
- Targeting and health insurance
- Community Health Worker
Coverage
Centre-Nord, Nord, Sud-Ouest, Centre-Est, Boucle du Mouhoun, Centre-Ouest
All health facilities in targeted districts
Producers and sponsors
| Name | Affiliation |
|---|---|
| Paul Jacob Robyn | The World Bank |
| Aurelia Souares | University of Heidelberg |
| Herve Hien | Centre Muraz |
| Name | Affiliation | Role |
|---|---|---|
| Haidara Ousmane Diadie | The World Bank | Task Team Leader (TTL) |
| Julia Lohmann | University of Heidelberg | Researcher |
| Saidou Hamadou | The World Bank | Survey Expert |
| Name |
|---|
| Health Results Innovation Trust Fund |
| Name | Affiliation |
|---|---|
| Ministry of Health | Government of Burkina Faso |
Sampling
All health facilities in the targeted districts were included in the study.
For 4 of the 6 regions, the primary health facilities were divided into 3 intervention arms within the intervention districts. For the following health districts: Batié, Diébougou, Ouargaye, Tenkodogo, Kaya, Kongoussi, Gourcy et Ouahigouya, the different health facilities were equally divided into the 3 intervention groups: T1, T2 and T3.
In the Boucle du Mouhoun region (Nouna and Solenzo districts), health facilities were divided into 2 groups: T1 and T4. For the 6th region, all health facilities were in T1, the targeting was not implemented. In this region, no randomization occurred.
The randomization happened during public ceremonies in each region. All health personal from the regional level (Direction Régionale de la Santé (DRS), District level (Equipe Cadre de District, (ECD)) and local level (health facilities and district hospital) were invited to participate.
Description of the intervention groups:
T1: PBF
T2: PBF + systematic targeting and subsidization for the poor
T3: PBF + systematic targeting and subsidization for the poor + providers motivation for poor consultations
T4: PBF + CBHI + systematic targeting and subsidization for the poor
Detailed information about randomization is available in the attached report.
100%
Survey instrument
The survey instruments are based on HRITF Impact Evaluation Toolkit templates. The facility-based survey comprised different tools for data collection with different data sources and respondents.
The following questionnaires/forms were implemented:
- Facility assessment module (Questionnaire F1)
- Health worker interview module (Questionnaire F2)
- Community health worker interview module (Questionnaire F8)
- Observations of patient-provider interaction module (Questionnaires F3 and F5)
- Patient exit interviews (Questionnaires F4, F6 and F7)
Data collection
| Start | End | Cycle |
|---|---|---|
| 2013-10-15 | 2014-03-30 | Baseline |
| Name |
|---|
| Centre Muraz |
Data collection took place from October 15th, 2013 to March 15th, 2014. The direct supervisors accompanied the investigators; there were teams of 10 investigators for the households and teams of 5 investigators for the health facilities. A household team and a health facility team were deployed in each region. A second level supervision was provided by 3 controllers: each controller was supervising 2 regions and, thus, each was responsible for 4 teams. Together, a 42 team of supervisors from Centre MURAZ and University of Heidelberg provided a third level of control of the investigators.
The health facility surveys were paper-based while the household surveys were conducted with PDAs. The data collected on-site was sent on weekly basis to the server in MURAZ Centre (the encoded data was sent electronically) and paper surveys were sent on a daily basis in sealed boxes to MURAZ center for data entry.
Depositor information
| Name | Affiliation |
|---|---|
| Paul Jacob Robyn | The World Bank |
Data Access
| Name | Affiliation | |
|---|---|---|
| Paul Jacob Robyn | The World Bank | probyn@worldbank.org |
| Is signing of a confidentiality declaration required? | Confidentiality declaration text |
|---|---|
| no | All data are anonymous. |
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,
Paul Jacob Robyn, The World Bank; Aurelia Souares, University of Heidelberg; Herve Hien, Centre Muraz. Burkina Faso Health Results-Based Financing Impact Evaluation 2013, Health Facility Baseline Survey (HRBFIE-FBL). Ref. BFA_2013_HRBFIE-FBL_v01_M. 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 | |
|---|---|---|
| Paul Jacob Robyn | The World Bank | probyn@worldbank.org |
Metadata production
DDI_BFA_2013_HRBFIE-FBL_v01_M_WB
| Name | Affiliation | Role |
|---|---|---|
| Development Data Group | The World Bank | Study documentation |
2016-12-16
Metadata version
v01 (December 2016)