Health Results Based Financing Impact Evaluation 2018, Health Facility Endline Survey

The major features of the sampling procedure include the following steps (they are discussed in more detail in a copy of the study's report located in "External Resources"):

Health Facilities:

1. Table 6-4 in the study's report presents the number of RHCs selected for the sample for each district. Of the 216 RHC selected for the sample (after randomly excluding some RHCs when the total was not divisible by three), 151 have subsidiary HHs. Forty-three HHs were selected of the sample in Sughd and 107 in Khatlon.
2. While some Rural Health Centers have one or more subsidiary Health Houses in their catchment areas, others do not have any. One Health House from each RHC with subsidiary HHs was to be included in the sample. The selection was random with each health house within a cluster having an identical probability of being chosen. Non-selected health houses were ranked to serve as replacements if the survey cannot be implemented in the selected HHs.

Households:

1. The evaluation relies on two samples of households. As the primary focus of the PBF intervention is on Maternal and Child Health (MCH) services, the main household sample is of households with women who experienced a recent pregnancy. This sample would not be appropriate to study the impact on the coverage of services related to Non-Communicable Diseases (NCD). Therefore, a second sample consists of households with individuals over the age of 40. The household samples are clustered according to the catchment area of each Rural Health Center (and its affiliated health houses).
2. The resulting targeted primary household sample size is of 4,320 households, with 20 in each of the 216 clusters in the six study arms. To be eligible to be included in the household survey sample, households must have had at least one woman aged 15-49 years who has had a child in the preceding three years. The same villages were covered for both the baseline and followed up survey and eligibility was determined at each round by a listing exercise.
3. The resulting targeted sample size for the secondary household sample is 1,584 households, with 22 in each of 72 clusters in two of the six study arms. Eligibility for this sample is determined by an individual over the age of 40 in the household. Eligibility for the two samples is determined by a common listing of households in selected villages. Households which satisfy both eligibility criteria can be randomly selected to count towards the sample size requirements for both.
4. A two-stage cluster sampling methodology was employed to identify random samples. First, villages were randomly selected out of a list of the villages served by each facility. The list was obtained from the MoH. RHCs have either single or multiple villages in their catchment areas while HHs typically serve a single village. If an RHC has at least one affiliated HH, then two villages were selected. One village was directly served by the RHC while the other included in the sub-catchment area of the HH. In each village, 100 households were listed. If the village had over 100 households, a random walk method was used to select the target number. A short questionnaire was conducted at each household to determine households' eligibility for the two samples. From all eligible households, the target sample for each catchment area was selected. In catchment areas in which two villages were included in the sample, half of the households were to be selected from each village.