Strategic Impact Evaluation Fund (SIEF) - Health Systems and Service Delivery Cluster
HEALTH SYSTEMS AND SERVICES DELIVERY
The Strategic Impact Evaluation Fund is a new multi-donor trust fund that supports research to evaluate the effectiveness of programs to improve people’s lives and alleviate poverty. The fund, which was started with the assistance of the British Government’s Department for International Development, recently announced the results of its first call for proposals. Thirty projects were picked for initial funding, among them five in the area of Health Systems and Service Delivery. Projects in the health cluster are listed below.
Impact of SMS-Enabled Report Cards on the Quality of Hospital Health Care Services in Georgia
World Bank contact: Owen Smith
Principal investigators: Owen Smith, World Bank, and Sebastian Bauhoff, RAND Corporation
Timeline: October 2012 to May 2015
Evaluation: In Georgia, quality of care is a major obstacle to progress on the health reform agenda. Researchers will study the impact of reporting quality of care to patients via mobile phones. The evaluation includes a component to develop a quality measurement tool based on administrative and claims data. Hospitals will receive detailed reports of their quality by mail, while patients can request (and receive) reports of nearby providers via text message on their mobile phone. The evaluation will help policymakers and health experts understand the effect of improving accountability on health care services, patient choices, and provider performance.
Impact Evaluation of a Health Insurance Pilot in Nepal
World Bank contact: Tekabe Belay
Principal investigators: Tekabe Belay, World Bank, and Tomas Lievens, Oxford Policy Management
Timeline: May 2013 to June 2015
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.
Healthy Mothers and Healthy Babies: Testing Demand and Supply-Side Approaches to Maternal and Child Health in Nigeria
World Bank contact: Vincenzo di Maro
Principal investigator: Pedro Rosa Dias, University of Sussex
Timeline: July 2012 to June 2016
Evaluation: In Nigeria, more than one in ten children will not survive to see a fifth birthday, and nearly one in twenty women will die in childbirth. Researchers will evaluate supply-side approaches to improving maternal and child health, including training and placing midwives and health workers in underserved rural areas, rehabilitating health facilities, and improving the distribution of medicine and equipment. This evaluation—the first of four requested by the Nigerian government—will help determine both the overall impact of the project in reducing infant and maternal mortality, and the appropriate mix of monetary and non-monetary incentives.
Impact of Quality Incentives in Primary Care (i-QIP)
World Bank contact: Sarbani Chakraborty
Principal investigators: John Peabody, University of California, San Francisco, and Orville Solon, University of the Philippines
Timeline: November 2012 to June 2015
Evaluation: In the Philippines, the government has sought to improve the effectiveness of health care delivery through a series of innovative, national-level policy changes that expanded primary care services. To ensure effective delivery, the government began a pay-for-performance incentive scheme in rural health clinics and municipal health centers, whereby the clinics themselves were given the money. The government is now interested in switching to bonus payments for clinical performance, based on new evidence that shows that monetary and non-monetary feedback given directly to the physician leads to higher quality care. Researchers will measure the effectiveness of direct payments to physicians in raising health outcomes and whether non-monetary approaches, combined with a bonus, accelerate improvements in the quality of care.
Improving Health Service Delivery through Community Monitoring and Non-Financial Awards
Location: Sierra Leone
World Bank contact: Qaiser Khan
Principal investigators: Oeindrila Dube, New York University; Johannes Haushofer, The Abdul Latif Jameel Poverty Action Lab; Vivek Maru,
Namati; Bilal Siddiqi, Center for the Study of African Economies, Oxford University
Timeline: May 2011 to October 2013
Evaluation: In Sierra Leone, basic health services are plagued by worker absenteeism, low utilization of health clinics, and a lack of basic care, including vaccinating children under five. The government sought to rectify these problems in 2010 by instituting free healthcare for pregnant women, new mothers, and children under five, abolishing user fees, and raising workers’ salaries. However, the system continues to face problems related to use of services and quality. Researchers will evaluate the relative effectiveness and potential for scale-up of two social-accountability interventions: competitions among clinics for non-financial awards, and community monitoring using health scorecards and community-clinic meetings.