Health Impact Evaluation in DRC

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IBTCI has been consigned by USAID to conduct an evaluation of its Integrated Health Project (IHP) currently being implemented by Management Sciences for Health in the Democratic Republic of Congo (DRC). Field implementation is assisted by the Centre de Communication et  d’Education pour la Santé et le Développement. IHP is active in 80 Health Zones across four provinces:  East Kasai, West Kasai, Katanga, and South Kivu.  The evaluation employs a cross-sectional, pre/post intervention study design with random selection of Health Zones, and is comprised of two separate studies:  a performance evaluation of the entire IHP project, and an impact evaluation of a Results Based Financing pilot to be implemented in eight Health Zones.  

The IHP Performance Evaluation is focused on measuring access to, and utilization of quality health services. The RBF Impact Evaluation will measure programmatic differences in the Health Zones where the health personnel and their supervisors in the Ministry of Public Health will receive cash payments for the achievement of performance targets related to maternal and child health, family planning, malaria and HIV/AIDS. Using the Lot Quality Assurance Sampling methodology, we selected a representative sample of health centers and a full sample of all General Referral Hospitals for both studies. In addition to these facility surveys, we are conducting client exit interview surveys to ascertain end-users’ satisfaction with services received and their perceived quality of the care. To complement the quantitative component of the IHP study, we are conducting interviews with stakeholders and focus group discussions with civil society.

The RBF Impact Evaluation also includes a robust household survey of over 3,600 women to reveal their practices and attitudes toward health care. Both the household survey and the client exit interviews reveal beneficiaries’ satisfaction and perspectives on the quality of care in public health facilities.In addition, the RBF study examines the costs incurred to implement the performance-based financing component which will be particularly relevant for the government and donors as they consider the future scale-up of the intervention. Results from these endline evaluations will illuminate important programmatic recommendations.  In particular, the RBF findings will provide hard evidence to the DRC to best understand both the benefits and ramifications of this state-of-the-art intervention which holds potential for health care reform.