Measuring and Understanding the Effects of a Performance Based Financing Scheme Applied to Nutrition Services in Burundi
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 90
- 主要终点
- Change in recovery rate of acute malnutrition in children below five years old over two years
研究概览
简要总结
The government of Burundi is implementing a new financing scheme in health centres. The objective is to provide additional financial compensations to health centres on the basis of their performance in nutrition activities: it consists in the introduction of criteria focusing on malnutrition prevention and care activities in the existing performance based financing (PBF) system.
The general objective of this study is to assess the effects of this new financing scheme, to document its impact and to study the chains through which it occurred. This study will provide key evidence for countries with an existing PBF scheme and confronted with malnutrition problems on the appropriateness to extend the strategy to nutrition services. If this impact evaluation brings positive results, this may have implications for the global fight against malnutrition.
详细描述
Background
Malnutrition is a huge problem in Burundi. In order to improve the provision of services at hospital, health center and community levels, the Ministry of Health is piloting the introduction of malnutrition prevention and care indicators within its performance based financing (PBF) scheme. Paying for units of services and for qualitative indicators is expected to enhance provision and quality of these nutrition services, as PBF has done, in Burundi and elsewhere, for several other services.
The Nutrition PBF intervention
The intervention focuses on children under five years old. It follows the standard PBF model in Burundi and combines quantitative indicators to encourage an increase in service delivery (see below) and qualitative indicators. Quality of nutrition activities is assessed quarterly, and a bonus or penalty is applied to subsidies received by the facilities according to their quality score.
Table: Incentivized indicators
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 6 Months 至 23 Months（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Living in the catchment area of a health center under the study
排除标准
- •Mother or tutor of the child not available for the survey
- •Head of household or husband of the mother of the child not available for the survey
结局指标
主要结局
Change in recovery rate of acute malnutrition in children below five years old over two years
时间窗: 26 months from baseline; endline survey in December 2016
Recovery rate of acute malnutrition in children below five years old is assessed through clinical files of acute malnutrition cases completed during the six-month periods preceding each survey (first wave: clinical files cover the March-August 2014 period; second wave: it covers the May-October 2016 period).
Difference in prevalence of acute malnutrition among children aged 6-23 months between Dec 2014 and Dec 2016
时间窗: Two years from baseline; endline survey in December 2016
Acute malnutrition is defined as: weight for height z-score\<-2 or mid-upper arm circumference\<125 mm
次要结局
- Difference in weight-for-Height Z-score among children aged 6-23 months between Dec 2014 and Dec 2016(Two years from baseline; endline survey in December 2016)
- Difference in prevalence of stunting among children aged 6-23 months between Dec 2014 and Dec 2016(Two years from baseline; endline survey in December 2016)