Health Results Based Financing Impact Evaluation 2015, Household Baseline Survey
Household Baseline Survey
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 (documented here) 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.
The household survey is documented here.
Kind of Data
Sample survey data [ssd]
The main themes covered in the household survey include:
• Socio-economic characteristics of the household
• Health behaviors for Maternal and Newborh Health (MNH) services
• Health seeking behaviors, barriers to use and health service use
• Household health expenditures
• Maternal health (recent pregnant sample)
• Anthropometric of children less than five (recent pregnant sample)
• Reproductive decisions
• General experience with Health Center (adolescent sample)
• General perceptions of health service quality
• Interactions with Village Health Workers (VHWs)
The baseline survey covers four districts: Mafeteng, Mohale’s Hoek, Mokhotlong and Thaba-Tseka.
The survey instrument was administered to women in the sampled households.
Producers and sponsors
DECHD, World Bank
Damien de Walque
DECHD, World Bank
Health Results Innovation Trust Fund, World Bank
The household sampling follows a two-stage strategy. Enumeration areas (EAs) were initially defined by the 2006 census but in case the enumeration area covered two different catchment areas, the EA was split into smaller units defined by the catchment areas. First, EAs within the catchment area of each health center were ranked for listing by random drawing. In each of the villages in the EA ranked first, a dedicated listing team did a household listing, collecting information on the presence of women who were pregnant in the preceding two years and of adolescent females. The listing team did a complete listing whether eligible or not. In cases in which the EA had less than 80 households or if less than 18 eligible households for any of the two samples were listed, the next ranked EA was added. Listing was always done at the EA level, i.e. all households in the EA were listed unless a village was not found by the listing team.
Second, up to 50 households were then randomly selected by the research team for survey. The selection of households was according to the following two criteria: (a) 25 households with at least one birth or pregnancy, regardless of the outcome of the pregnancy, in the two years preceding the survey; (b) 25 households with at least one adolescent girl. In cases with less than 25 eligible households listed, all eligible households were selected for the survey. The selection of the ‘recent pregnancy’ and of the ‘adolescent’ sample was done separately. However, in some cases, the same household was randomly selected for both samples.
The final household sample includes 2120 households. From these the research team was able to link 1252 female questionnaires and 972 adolescent questionnaires. Deleted from the raw sample were 41 female questionnaires and 9 adolescent questionnaires that could not be matched to a household roster.
The overall selection probability of a household is the product of the selection probabilities of the two stages (See formula on p8 of the survey report provided under the Related Materials tab). The research team calculated the sample weights as the inverse of the selection probability.
Dates of Data Collection
Data Collection Mode
Four field teams were trained to do the household survey and the survey was pre-tested before the implementation. Each team consisted of one supervisor and five interviewers. The interviewers reported directly to their supervisor, while the supervisors reported directly to the manager. Given the potentially sensitive topics related to reproductive health covered in the survey, all interviewers and supervisors were women.
Data Collection Notes
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.
The baseline household survey data was collected using the following 3 questionnaires:
- Household Questionnaire
- Household Questionnaire: Selected Woman 1
- Household Questionnaire: Selected Woman 2
The World Bank
- 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
Shapira, Gil., Damien de Walque (World Bank). Lesotho Health Results Based Financing Impact Evaluation 2015 (HRBFIE-FBL), Household Baseline Survey. Ref. LSO_2015_HRBFIE-HBL_v01_M.The World Bank. Dataset downloaded from [URL] on [date].
The World Bank
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.