Health Results-Based Financing Impact Evaluation 2014, Baseline Survey
Other Household Health Survey
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.
Despite some moderate improvements, reproductive, maternal and child health indicators continue to perform poorly in the Republic of Congo. To increase the quality and utilization of maternal and child health services, a supply-side performance-based financing (PBF) scheme was introduced. Under this scheme, the Ministry of Health and Population (MOHP) contracts and incentivizes health centers and first level referral hospitals to respectively expand the coverage and improve quality of services. The PBF payment mechanism also includes penalties to discourage fraud.
In parallel, the poject is also piloting a demand-side PBF scheme, where PBF health facilities contract and incentivize community relays – composed of health facility staff and community health workers from the community – to support households in adopting positive behaviors.
In collaboration with the Ministry of Health and the Ministry of Social Affairs, the World Bank team has developed a design to assess the impact of PBF interventions.
The impact evaluation examines the combination of performance-based financing, community-based targeting and subsidization of health services provided to the poor and household visits, according to an established protocol. PBF is implemented at the district level (with control districts in the same departments) and the demand-side interventions are randomized at the health facility level.
The baseline survey was conducted in 2014 and covered 7,800 households, 285 primary care health facilities and 35 district hospitals. The second round of the impact evaluation is planned for mid-2018; the endline survey is planned for mid-2019.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities and households
v01, edited, anonymous datasets
- Household socio-economic status (consumption, expenditure, revenues and household assets)
- Health seeking behaviors, barriers to use and health service use
- Household health expenditures
- General perceptions of health service quality health services
- Anthropometric measures for children younger than 5 years old
- General characteristics of the facility
- Maternal health: utilization indicators
- Quality of care: maternal and under-five health services
- Child health: utilization indicators
- Human Resources and Management of Health Care Facilities
- Targeting and health insurance
- Community Health Worker
Producers and sponsors
Paul Jacob Robyn
Harvard School of Public Health
Task team leader (TTL)
Health Results Innovation Trust Fund
The sample for the baseline is representative at the national level and is based on a stratified two-stage sampling method.
The sampling frame was the enumeration areas (EA) of 2007 General Population and Housing Census of the Republic of Congo.
At the first stage, 312 EAs were drawn proportionally to their size. All EAs selected were subject to a comprehensive household count.
At the second stage, 25 households were drawn in each EA of which:
- 20 households meeting the eligibility criteria (households with at least one pregnant woman or one non-pregnant woman at the time of the survey with a child born during the two years preceding the survey);
- 5 households meeting the criteria to be classified as a poor household, in addition to the abovementioned eligibility criteria.
A total of 7,800 households in all departments of the Congo were expected to be surveyed in 312 EAs sampled.
The health facility survey was carried out in all 285 primary care facilities and all district hospitals in the country. A sample of health workers, patient-caregiver observations and client interviews was selected. All survey visits were unannounced.
Dates of Data Collection
Data Collection Mode
Gervais Yama, World Bank
Saidou Hamadou, World Bank
The following survey instruments were used in the baseline:
- Household Survey Questionnaire
- Health facilities tools: health facility assessment, assessment of health facilities records, providers' questionnaire, direct observations, and patient exit interviews.
Paul Jacob Robyn
Harvard School of Public Health
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
Paul Jacob Robyn, The World Bank. Congo, Rep. Health Results-Based Financing Impact Evaluation 2014, Baseline Survey (HRBFIE-BL). Ref. COG_2014_HRBFIE-BL_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.
DDI Document ID
Development Data Group
The World Bank
Documentation of the DDI
Date of Metadata Production
DDI Document version
v01 (September 2015) - literal questions for datasets' variables filled