Health Results-Based Financing Impact Evaluation 2012, Household Baseline Survey
Household Baseline Survey
Other Household Survey [hh/oth]
Scaling-up of performance-based financing (PBF) schemes across sub-Saharan Africa (SSA) has developed rapidly over the past few years. Many studies have shown a positive association between PBF and health service coverage, and some with improvements in quality. However, a lack of controls and confounders in most studies that have been published on PBF initiatives means that the impact of PBF initiatives on service coverage, quality and health outcomes remains open to question. Moreover, few studies have examined the factors that influence the impact of PBF- an area of considerable operational significance since PBF often involves a package of constituent interventions: linking payment and results, independent verification of results, managerial autonomy to facilities and enhanced systematic supervision of facilities. As a result, the policy objectives of the following Impact Evaluation are to: (a) identify the impact of PBF on Maternal and Child Health (MCH) service coverage and quality; (b) identify key factors responsible for this impact; and (c) assess cost-effectiveness of PBF as a strategy to improve coverage and quality. The results from the impact evaluation will be useful to designing national PBF policy in Cameroon and will also contribute to the larger body of knowledge on Performance-based Financing (PBF).
The impact evaluation is a blocked-by-region cluster-randomized trial (CRT), having a pre-post with comparison design. The evaluation relies primarily on experimental control to answer the main research questions for this study. The evaluation relied on two main sources of data:
- Household surveys: A household survey was implemented at baseline (i.e., before implementation of PBF begins), and at endline (i.e., after PBF has been implemented for two years).
- Facility-based surveys: A facility-based survey was implemented at baseline and at endline.
Note: The Health Facility Baseline Survey is available online under Impact Evaluation Surveys Collection. The study is titled "Health Results-Based Financing Impact Evaluation 2012, Health Facility Baseline Survey."
Kind of Data
Sample survey data [ssd]
Unit of Analysis
The target population for the household baseline survey is households with at least one pregnant woman or a woman with a child who was born during the two years preceding the survey.
The main themes covered in the household survey include:
- Health behaviors for Maternal and Child Health services
- Health seeking behaviors, barriers to use and health service use
- Household health expenditures
- General perceptions of health service quality
- Household demographic characteristics
- Economic activity
- Household living conditions
Littoral, North-West, South-West and East regions of Cameroon.
Producers and sponsors
Damien de Walque
Paul Jacob Robyn
To select the households to be surveyed, a catchment area was established for each of the 245 primary care facilities. No more than 16 households were randomly selected for survey in the catchment area of each selected health facility. Only households with at least one pregnancy or birth in the 2 years preceding the survey were eligible for inclusion. The household survey sample covered 3874 households - 5296 women of reproductive age (15-49 years), 3380 non-pregnant women at the time of the evaluation, and 5867 children under five years old.
Dates of Data Collection
Data Collection Mode
Data Collection Notes
Households surveyed at baseline will also be visited at endline, and will be included in the endline sample if they continue to meet eligibility criteria. Additional households may be sampled at endline if necessary to meet sample size requirements.
The impact evaluation collected data on service coverage and health behaviors using household surveys, while facility surveys were implemented for the quality indicators. Both household and facility surveys were conducted by a third party research firm that is not involved in any aspect of RBF implementation.
The household questionnaire is composed to two parts: the first is a household survey for all members of the household, while the second part is specifically for women between 15-49.
In addition to the questionnaires, the survey teams did the following:
(1) Conduct rapid diagnostic tests for malaria for all children aged under 5 and currently pregnant women present in the household during the visit,
(2) Conduct rapid diagnostic tests for anemia for all children aged under 5 and non-pregnant women who have delivered a baby in the preceding 2 years present in the household during the visit, and
(3) Weigh and measure the height of all children aged under 5 years present in the household during the survey team's visit.
Damien de Walque
The World Bank
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
Damien de Walque, The World Bank. Health Results-Based Financing Impact Evaluation 2012, Household Baseline Survey (RBFIE-HBL) 2012. Ref. CMR_2012_RBFIE-HBL_v01_M. Dataset downloaded from [URL] on [date].
Damien de Walque
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.