Measuring and Understanding the Effects of a Performance Based Financing Scheme Applied to Nutrition Services in Burundi

Summary

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.

Conditions

• Malnutrition

Interventions

OTHER

Nutrition PBF

Nutrition PBF 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 Table 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 CHW level * nb of cases screened and referred to HC for acute malnutrition (AM) * nb of classes promoting good nutrition HC level * nb of cases screened and cared for severe and moderate AM * nb of growth follow-ups Hospital level * nb of treated severe AM cases with complications * length of the stay All hospitals with nutrition services fall under the Nutrition PBF program. At lower levels, only HCs in the intervention group and the CHW that refer to them are subject to the Nutrition PBF.

Sponsors & Collaborators

• World Bank

  collaborator OTHER

• Ministry of Health, Burundi

  collaborator OTHER_GOV

• Institut de Statistiques, Burundi (ISTEEBU)

  collaborator UNKNOWN

• Institut National de Santé Publique, Burundi (INSP)

  collaborator UNKNOWN

• Institute of Tropical Medicine, Belgium

  lead OTHER

Principal Investigators

• Catherine Korachais, PhD · Institute of Tropical Medicine of Antwerp, Belgium

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

6 Months

Max Age

23 Months

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2014-12-31

Primary Completion

2017-04-30

Completion

2018-05-31