Measuring and Understanding the Effects of a Performance Based Financing Scheme Applied to Nutrition Services in Burundi (NutriPBF)
|ClinicalTrials.gov Identifier: NCT02721160|
Recruitment Status : Active, not recruiting
First Posted : March 29, 2016
Last Update Posted : March 3, 2017
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.
|Condition or disease||Intervention/treatment|
|Malnutrition||Other: Nutrition PBF|
Show Detailed Description
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||90 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Health Services Research|
|Official Title:||Measuring and Understanding the Effects of a Performance Based Financing Scheme Applied to Nutrition Services in Burundi|
|Study Start Date :||December 2014|
|Estimated Primary Completion Date :||July 2017|
|Estimated Study Completion Date :||July 2017|
Experimental: Nutrition PBF
45 health centres are assigned to this group. The intervention consists in a performance based financing scheme applied to nutrition services.
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
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.
No Intervention: Control
45 health centres are in the control group. Health centres in this group are not incentivized, but they receive an equivalent funding to the one received by the intervention group. The main difference is that this payment is not based on their own performance.
- Change in recovery rate of acute malnutrition in children below five years old over two years [ Time Frame: 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 [ Time Frame: 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
- Difference in prevalence of stunting among children aged 6-23 months between Dec 2014 and Dec 2016 [ Time Frame: Two years from baseline; endline survey in December 2016 ]Stunting is defined as: height for age z-score<-2
- Difference in weight-for-Height Z-score among children aged 6-23 months between Dec 2014 and Dec 2016 [ Time Frame: Two years from baseline; endline survey in December 2016 ]The weight for height Z-score expresses the weight for height ratio as a number of standard deviations or Z-scores below or above the reference mean or median value; which here is based on the NCHS/WHO international reference population.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02721160
|Principal Investigator:||Catherine Korachais, PhD||Institute of Tropical Medicine of Antwerp, Belgium|