Scaling-up of performance-based financing (PBF) has never been systematically evaluated in Central African Republic (CAR) on any meaningful scale. As such, this Impact Evalution's larger policy objectives are to:
  • identify the impact of PBF on maternal and child health (MCH) service coverage and quality,
  • identify key factors responsible for this impact, and
  • assess cost-effectiveness of PBF as a strategy to improve coverage and quality.
In doing so, the results from the impact evaluation will be useful to designing national PBF policy in CAR and will also contribute to the larger body of knowledge on PBF. The evaluation will rely on two main sources of data:
  • Household surveys: A household survey will be implemented at baseline (i.e., before implementation of PBF begins), and at endline (i.e., after PBF has been implemented for two years).
  • Facility-based surveys: A facility-based survey will be implemented at baseline and at endline.
The main targeted outcomes fall into two main groups:
  • Maternal and Child Health Service coverage indicators and
  • Quality of care indicators.

The study is a blocked-by-region cluster-randomized trial (CRT), having a pre-post with comparison design. The team relied primarily on experimental control to answer the main research questions for this study. The study will also include a qualitative component at endline to probe deeper for explanations or explore specific issues that are relevant to PBF.