HEALTH SYSTEMS AND SERVICE DELIVERY
In many developing countries, weak health systems and the prevalence of often-preventable diseases undermine efforts to reduce poverty and improve opportunities for people to build better lives for themselves and their children. SIEF-supported researchers are working with health ministries and non-governmental organizations to measure the effectiveness of new and existing initiatives to strengthen access to and quality of care, including better services for women and girls. The evidence generated will make it possible for development practitioners and policymakers around the world to learn what’s working and how they can apply these lessons for better health care and coverage for all. Read more about health and impact evaluation in our Cluster Note.
PORTFOLIO OF IMPACT EVALUATIONS
- Timeline: Completed (Funded under SIEF 1)
- Evaluation: Researchers conducted a randomized experiment to evaluate the impact of the Nahouri Cash Transfers Pilot Project in Burkina Faso’s Nahouri province, where poor families received either conditional or unconditional grants to encourage them to enroll their children in school and take them for regular check-ups. The program ran from 2008-2010. The evaluation results helped the Government of Burkina Faso, working with the World Bank, develop a new social safety net program for the country. For further infromation, see our Burkina Faso Impact page.
- Principal Investigators: Manoj Mohanan, Duke University; Harsha Thirumurthy, University of North Carolina at Chapel Hill
- Timeline: 2014 – 2019
- Evaluation: Uttar Pradesh, India’s largest state, with a population of more than 200 million, has among the lowest per-capita incomes in the country. Infant and child mortality rates are especially high and some 380,000 children under the age of five die every year. The Government of Uttar Pradesh, which seeks to improve its health care system, is piloting social accountability interventions and considering them for scale-up as part of a World Bank-supported project. Researchers are working with the government to evaluate the effectiveness of these campaigns.
- Principal investigators: Jessica Goldberg, University of Maryland; Mario Macis, Johns Hopkins University
- Timeline: 2014 - 2017
- Evaluation: About 3.5 million people in India are estimated to have tuberculosis, and one third of them either haven’t been diagnosed or aren’t receiving treatment. Infected people are often from the most vulnerable and marginalized communities and it’s difficult to make sure they know about treatments and how to minimize the spread of disease. The India-based non-governmental organization Operation ASHA, which operates 200 tuberculosis treatment centers, is piloting a program that pays current patients for referring people who might have tuberculosis to government testing centers. Researchers working with the group will carry out a randomized controlled trial to evaluate the program and the results will help tuberculosis experts worldwide understand what can – or cannot – improve outreach and treatment to those at risk.
- Principal investigators: Jishnu Das, World Bank; Guadalupe Bedoya, World Bank
- Timeline: 2015 - 2019
- Evaluation: In Kenya, where clinics have limited budgets and health care quality is low, researchers are looking at how increased monitoring and providing information to patients about the clinics that serve them can improve the quality of care. The Government of Kenya wants to develop better approaches for monitoring and improving health care throughout the country, and this evaluation will provide the government with evidence for policies to strengthen the quality of care in private and public facilities.
Nepal: Impact Evaluation of a Health Insurance Pilot
- Principal investigators: Tekabe Belay, World Bank; Santadarshan Sadhu, Institute of Financial Management and Research (India)
- Timeline: Cancelled
- Evaluation: Nepal’s out-of-pocket health costs are rising and inequalities in access to health care are increasing. To combat this, the Ministry of Health and Population has been working to develop a strategy for universal health coverage. A proposed pilot project aims to determine the best insurance policy and overall financing strategy. Researchers hope to identify effective financing methods for the provision of comprehensive and equitable health services in low-income settings. Baseline data was collected (not yet publicly accessible).
- Principal investigators: Pedro Rosa Dias, University of Sussex; Marcos Vera-Hernandez, University College London; Marcus Holmlund, World Bank
- Timeline: 2013 - 2016
- Evaluation: In Nigeria, approximately one million mothers and children die every year from preventable diseases. Three-quarters of these deaths wouldn't happen if existing healthcare services were used. Nigeria seeks to reduce deaths from preventable diseases by improving use and quality of healthcare services available for women and children through its Subsidy Reinvestment and Empowerment Programme (SURE-P) Maternal and Child Health Program. Researchers will evaluate various interventions within the program.
Philippines: Impact of Incentives and Information on Quality and Utilization in Primary Care (i3QUIP)
- Principal investigators: Junko Onishi, World Bank; Taejong Kim, Korean Development Institute School of Public Policy and Management; John Basa, Philippines Health Insurance Corporation
- Timeline: Cancelled
- Evaluation: In the Philippines, the government has sought to improve the effectiveness of primary health care by expanding coverage of PhilHealth's social health insurance benefit package. Researchers will examine the impact of three measures being implemented: (i) direct payments to providers with increased autonomy on the distribution of the amount, (ii) increased disclosure of information, and (iii) a combination of direct payments and increased disclosure of information. Baseline data was collected (not yet publicly accessible).
Tanzania:“RESPECT Study for women at high risk of HIV infection in Dar-es-Salaam, Tanzania”
- Principal investigators: Damien de Walque, World Bank; William H. Dow, University of California, Berkeley; Admirabilis Kalolella, Ifakara Health Institute
- Timeline: 2014 - 2017
- Evaluation: HIV prevention remains a top priority for the global health community, especially in sub-Saharan Africa, where 70 percent of the world’s estimated 25 million HIV-infected people currently live. Information campaigns to discourage risky sexual behavior have had limited success. Researchers are exploring the impact of using financial incentives to encourage safe sex in order to stem the spread of HIV. The evaluation in Tanzania will focus on high risk populations, such as female sex workers, to see if cash payments conditional on testing negative for HIV and other sexually-transmitted infections can help reduce risky behavior.