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Impact Evaluation Note
ARMENIA
GOA: Saro Tsaturyan, Yervand Elibekyan, !
Task team: Wezi Msisha, Susanna Hayrapetyan!
IE t...
Background (1)
•  Nation-wide RBF in PHC since 2011
•  Government-funded, covering 350 PHC facilities
•  RBF on top of cap...
Background (2)
•  Payment frequency – annual (second quarter of
next year)
•  Bonus payments amount to 5 to 7 percent of
p...
2. Description of Intervention
From July 2014, WB will pool $ with GoA to
Nation-wide
•  Add 3 more indicators for screeni...
Description of Intervention (2)
Interventions for a subset of health
facilities
-  Quarterly supportive QoC
supervision by...
4. Primary Research Questions
For the nation-wide RBF:
1. Does the RBF improve providers
performance related to the new in...
5. Outcome Indicators
For the first research question:
•  Indicators related to coverage of MCH and
NCD interventions unde...
6. Identification Strategy/ Method
1. First research question: before-and-after 
2. Last two questions: Randomized Contro...
7. Data source
•  Household surveys
•  Facility surveys
•  Provider surveys (including direct
observation, chart review)
•...
8. Time Frame / Work Plan
•  Baseline survey for question 1 (before and
after): 2012 HHS, facility and provider surveys
• ...
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Annual Results and Impact Evaluation Workshop for RBF - Day Eight - Impact Evaluation Note - Armenia

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A presentation from the 2014 Annual Results and Impact Evaluation Workshop for RBF, held in Buenos Aires, Argentina. French version.

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Transcript of "Annual Results and Impact Evaluation Workshop for RBF - Day Eight - Impact Evaluation Note - Armenia "

  1. 1. Impact Evaluation Note ARMENIA GOA: Saro Tsaturyan, Yervand Elibekyan, ! Task team: Wezi Msisha, Susanna Hayrapetyan! IE team: Son-Nam Nguyen, Kent Ranson H E A LTH R ESU LTS IN NOVATION TRUS T FU N D
  2. 2. Background (1) •  Nation-wide RBF in PHC since 2011 •  Government-funded, covering 350 PHC facilities •  RBF on top of capitation payment mechanism •  Started with 10 performance indicators (2011) •  Increased to 30 indicators in 2012 •  Each visit to PHC provider is registered with special form, then entered into electronic HIM system •  Electronic reports are presented to State Health Agency of MoH on a monthly basis, and are summarized annually for payment 2
  3. 3. Background (2) •  Payment frequency – annual (second quarter of next year) •  Bonus payments amount to 5 to 7 percent of providers’ annual income •  Indicators cover: o  Disease prevention (6 indicators) o  Control of chronic diseases (7 indicators) o  Maternal and Reproductive Health (3 indicators) o  Child Care (7 indicators) o  TB detection (1 indicator) o  Maintaining Electronic Registers of Patients with certain Diseases (6 indicators). 3
  4. 4. 2. Description of Intervention From July 2014, WB will pool $ with GoA to Nation-wide •  Add 3 more indicators for screening of diseases (cervical cancer, diabetes, hypertension) •  Increase size & frequency of incentives •  Strengthen verification of results For a sub-set of facilities •  Test different supplementary interventions to enhance RBF scheme 4
  5. 5. Description of Intervention (2) Interventions for a subset of health facilities -  Quarterly supportive QoC supervision by MOH to 30 facilities -  Quarterly clinical vignettes administered to PHC providers in 30 facilities and feedbacks
  6. 6. 4. Primary Research Questions For the nation-wide RBF: 1. Does the RBF improve providers performance related to the new indicators? For a subset of facilities 2. Does regular QoC supportive supervision improve quality of care under RBF scheme? 3. Do regular vignettes and feedbacks improve quality of care under RBF scheme? 6
  7. 7. 5. Outcome Indicators For the first research question: •  Indicators related to coverage of MCH and NCD interventions under RBF scheme For the last two research questions: •  Focus on indicators related to quality of care (clinical processes) related to MCH and NCD •  We will also consider possible health outcome indicators 7
  8. 8. 6. Identification Strategy/ Method 1. First research question: before-and-after  2. Last two questions: Randomized Controlled Trial  90 PHC facilities will be randomly selected and assigned into 3 arms: -  Arm 1: QoC supportive supervision visit -  Arm 2: Regular clinical vignettes and feedbacks to providers -  Arm 3: Control 8
  9. 9. 7. Data source •  Household surveys •  Facility surveys •  Provider surveys (including direct observation, chart review) •  Routine HMIS data •  Qualitative data from IDI and FGD 9
  10. 10. 8. Time Frame / Work Plan •  Baseline survey for question 1 (before and after): 2012 HHS, facility and provider surveys •  Concept note: May 2014 •  Baseline for questions 2 and 3: facility and provider surveys in September 2014 •  Implementation of interventions for 60 health facilities: Jan 2015-Dec 2016 •  End-line surveys: Jan 2017 10
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