Impact Evaluation Comparing Different Demand-Side Incentives for Health Screenings 2019-2020
Baseline and Endline Surveys
Other Household Health Survey [hh/hea]
The Baseline Survey data collection took place from 2019-07-22 to 2019-09-02
The Endline Survey data collection took place from 2020-01-10 to 2020-02-10.
Despite repeated efforts both on the supply side (improving facility equipment and supplies, and financial incentives to providers) and on the demand side (communication campaign including mass-media outreach), screening rates for diabetes and hypertension are still lagging in the Armenian population. Hypertension and diabetes are among the top drivers of preventable death and disability due to non-communicable diseases in Armenia. The focus of this evaluation will be on increasing screening rates for diabetes and hypertension for males and females ages 35-68. Current screening rates are: diabetes mellitus, females 48.1%, males 30.9%; hypertension, females 75.4%; males 48.3%. We will evaluate different types of demand-side incentives to increase the take-up of the screenings. We will compare regular incentives for patients to come for screenings, including personal invitations, personal invitations mentioning that peers have tested, a labeled but unconditional cash transfer (in the form of “cash like” pharmacy voucher) and a conditional cash transfer, also in the form of a pharmacy voucher.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Individual interview conducted at the household level
This endline survey has a total of 2000 study participants aged 35-to 68 for diabetes and hypertension in the last 12 months in 4 regions of Armenia compared to 1600 participants in the baseline. This is because the individuals randomly assigned to the control group were only administered the baseline questionnaire at the end of the intervention so as not to influence individual’s decision to screen for diabetes and hypertension. For the endline survey, a questionnaire was administered to the control group as well as the extraction of the screening status from the Armenian e-health administrative data system was conducted on all 2,000 individuals.
4 Marzes: Ararat, Armavir, Kotayq, Lori
Males and Females aged 35-68 who have not been screened for diabetes and hypertension in the last 12 months in the 4 above mentioned regions of Armenia.
Producers and sponsors
Damien de Walque
The World Bank, Development Research Group
The World Bank, HNP GP
The World Bank, HNP GP
Strategic Impact Evaluation Fund
Health Results Innovation Trust Fund
We used the administrative records of the public health clinics in Armenia. Armenia has a nationwide e-health system that is updated following the patients' visits. Because the health sector is dominated by public health facilities, we are very likely to have information on most of the diabetes and hypertension screening tests conducted. We first randomly selected public health facilities in urban and rural areas that will be sufficient to reach our desired sample size of 2000 individuals. From the patient records at these public health facilities, we then randomly drew our experimental sample, proportionally to the size of the catchment population of the health facilities, from the list of individuals 35-68 who have not been screened in the last 12 months.
From the control group, 400 individuals were administered the baseline questionnaire at the end of the intervention between January 2020 and February 2020. All 400 individuals granted consent for participation for a 100 percent response rate. It is also during this time that the extraction of the screening status from the Armenian e-health administrative data system was conducted on the 1600 study participants from the intervention groups and the 400 participants from the control group, for a total of 2,000 individuals.
Deviations from the Sample Design
Note that to avoid contamination of the control group by asking specific questions about diabetes and hypertension screening, the baseline survey was not administered to the control group between July and September 2019 but instead was administered between January 2020 and February 2020, at the end of the intervention period. This short rime difference in administering a survey consisting of questions linked to fairly stable socio-demographic variables was deemed preferable to the risk of changing the behavior of the control group by asking them health specific questions and in particular asking them why they had not screened in the last 12 months.
Baseline: A total of 1641 individuals were contacted for F2F visit in four regions, of them 1600 individuals granted consent for participation. The response rate (percentage of individuals who agreed to participate) across targeted communities stands at 97.5%.
The baseline and endline questionnaires were administered in English, they are provided for download as related materials.
Dates of Data Collection
Mode of data collection
Computer Assisted Personal Interview [capi]
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
The World Bank Group, de Walque, Damien, Adanna Chukwuma and Marianna Koshkakaruan. Armenia - Impact Evaluation Comparing Different Demand-Side Inentives for Health Screenings, Baseline and Endline Surveys (DSIHSIE) 2019-2020, Ref. ARM_2019-2020_DSIHSIE_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.
Data is provided as is.