Using RBF to Improve the Delivery of Maternal and Child Health Services in Zambia: Impact Evaluation Results
Zambia’s Results-Based Financing pilot project began in April 2012 in 11 rural districts, representing nine provinces out of a total of ten, 204 health facilities, and a total catchment population of nearly 1.7 million. The Zambian RBF model is one of the very few examples of “contracting in” with a view to build on and strengthen the existing public health system. The program was designed to help address various health system challenges including an insufficient and poorly motivated human-resource base; an erratic supply of essential medicines and medical supplies; limited autonomy in decision-making at decentralized levels of the health system; weak monitoring and evaluation systems; and poor quality of service delivery.
The Zambia RBF impact evaluation is unique in that the RBF model was tested against two alternative models of health service delivery: control group 1, where districts were to receive additional funding in an amount intended to be equivalent to the RBF districts had to be used for the delivery of maternal and child health-related interventions and could not be used for salaries; and control group 2, the “business-as-usual” model. Health facilities in 10 of the 11 RBF districts were evaluated against 10 control group 1 districts, while 10 other districts served as a second control (business as usual). Qualitative research on cost-effectiveness, HRH, and process evaluation complemented the IE. This session will focus on presenting the results of the impact evaluation and provide an overview of some of the key messages and policy implications of the work.
Coffee and light snacks will be served.