Purpose
In 2016, Chr. Michelsen Institute (CMI) and its partners, the Norwegian School of Economics, Ifakara Health Institute, and London School of Hygiene and Tropical Medicine, began implementing a rigorous impact and process evaluation of the Results-Based Financing (RBF) scheme for health in Tanzania. The scheme is designed to improve health service use and equity, as well as the quality and efficiency of health care, particularly among primary health care facilities. The main aim of the RBF scheme is to enhance the autonomy of facilities in regard to planning, budgeting and managing resources, with an element of output-based financing. Specifically, the RBF scheme includes a comprehensive set of performance indicators and incentive mechanisms, including incentives for health workers and community health workers (CHWs). The aim of the study was to evaluate the impact of the RBF scheme using a process evaluation, which involved regular data gathering at the national and district levels at dispensaries and health centres in three intervention districts, as well as conducting interviews with CHWs and health workers across health facilities, in Mwanza and Mara regions.
Action
EDI Global was contracted by CMI to conduct three rounds of phone interviews between 2018 and 2020 with health workers and CHWs in Mwanza region and Mara region. EDI Global led the preparation of the phone survey tools, the programming of computer-assisted personal interviewing (CAPI) software, the training of phone interviewers, as well as the implementation and oversight of all data collection and data quality work. EDI Global developed effective phone tracking and replacements protocols across each round to maximise the re-interview rate and to identify suitable replacements for CHWs and health workers who were no longer eligible for the survey. This protocol allowed EDI Global to successfully complete 1,069 phone interviews and to achieve a survey rate of an average of 95% of the CHW sample across the three rounds.
Impact
EDI Global conducted three rounds of phone surveys for the process evaluation of the RBF Scale-up Project, including the following:
interviews across three phone survey rounds
CHW interviews
health worker interviews
of the targeted number of phone interviews, including interviews of replacements
average survey rate for the CHW interviews
The reports of each round of the process evaluation are publicly available here. EDI Global’s team has also published several blogs relating to the implementation of the remote survey of health facilities:
