Impact Evaluation of Service Delivery Grants (SDGs) in the Health Sector in Cambodia: Endline Survey

Location

Cambodia. Location within country: 23 provinces/municipalities (Banteay Meanchey, Battambang, Pailin, Kampong Cham, Kampong Chhnang, Kampong Speu, Kampong Thom, Kampot, Kep, Kandal, Kratie, Mondulkiri, Oddar Meanchey, Phnom Penh, Prey Veng, Pursat, Ratanakiri, Siem Reap, Sihanoukville, Stung Treng, Svay Rieng, Takeo, Tboung Khmum)

Project Description

The World Bank, in collaboration with the Ministry of Health (MOH), is supporting the redesign of Service Delivery Grants (SDGs) that will be implemented as part of the larger Health Equity and Quality Improvement Project (H-EQIP). H-EQIP aims to increase the sustainability of these innovations by improving their resourcing and management as envisaged in the government’s Health Strategic Plan 2016-2020 (HSP3). It will further strengthen the results-based focus of SDGs with a specific goal of improving quality of health service delivery and utilization of services by the poor and will use a multi-pronged approach to strengthening health systems, especially to support improvements in quality of care.

As part of its support, WB designed a rigorous impact evaluation to measure improvements in quality (and quantity) of health service delivery attributed to the SDGs. The results from this quantitative evaluation are expected to inform the Royal Government of Cambodia (RGC) and Development Partners on the efficacy of the proposed intervention. Impact evaluation will take place at the same 3 levels where SDGs are inputted: health centers, hospitals and operational districts (ODs).

At the endline, Angkor Research’s involvement in this large-scale, randomized control trial included sample selection, instrument review/translation (from the WB RBF IE Toolkit, with back-translation), primary CAPI data collection (tablet-based) and data management for surveys of both the demand-side and supply-side aspects of health care utilization and access, to evaluate the effects of SDGs on a range of household, service delivery and health care indicators.

The sample is nationally representative, and covered 70 ODs in 23 provinces of Cambodia. On the supply-side, Angkor Research conducted interviews with 70 OD directors, health facility evaluations at 140 public health centers (including medical record audits and drug/medical equipment inventories), 545 interviews with medical staff (including situational vignettes), and 1,000 exit interviews with patients. In the catchment areas of the target health centers, 2,500 households were interviewed on a range of indicators, including health equity fund (HEF) status anthropometrics, health-seeking behavior, out-of-pocket health expenditures and maternal/child health. Household data is longitudinal, and can be linked between survey rounds. Data collection also includes interviews with village authorities and GPS locations in all villages. The household survey was completed with a 98.7% response rate.

Focus Group Discussions with the Beneficiaries of the COVID-19 Relief Transfer for the Poor Program in Cambodia

Location

Cambodia. Location within country: 25 provinces/municipalities (Banteay Meanchey, Battambang, Kampong Cham, Kampong Chhnang, Kampong Speu, Kampong Thom, Kampot, Kandal, Kep, Koh Kong, Kracheh, Mondulkiri, Oddar Meanchey, Pailin, Phnom Penh, Preah Sihanouk, Preah Vihear, Prey Veng, Pursat, Rattanakiri, Siem Reap, Stung Treng, Svay Rieng, Takeo, and Tboung Khmum)

Project Description

In June 2020, the Royal Government of Cambodia began providing recurring monthly cash payouts to households with the IDPoor designation throughout the kingdom in response to the COVID-19 global pandemic. The amount offered varies based on locality, household demographics, and IDPoor status (IDPoor Level 1 and IDPoor Level 2). The payout was originally intended to cover two months and has seen extensions since. The project sought to understand the procedure for recipients and needs being addressed by the programme, as well as identify challenges and weaknesses in the cash transfer mechanism to improve future programmes provided by the Royal Government of Cambodia.

After winning the public bid for the project, Angkor Research was awarded the contract from the World Bank. Angkor Research was responsible for all components of the data collection and data management, including: sampling methodology, framework and selection; instrument design, translation and pre-testing; data collection; data entry and data management; transcription, translation and coding of all qualitative data; quantitative and qualitative data analysis; and report writing. Due to COVID-19 restrictions and concerns of widespread transmission, Angkor Research advocated for and succeeded in revising the methodology where 30 FGDs became 180 telephone interviews with cash transfer programme beneficiaries.

Reproductive, Maternal and Neonatal Health Knowledge, Attitudes and Practices among Garment Factory Workers: Endline Survey

Location

Cambodia. Location within country: (8 provinces)

Project Summary

Partnering to Save Lives (PSL) is a partnership between the Ministry of Health (MoH), CARE, Marie Stopes International Cambodia (Marie Stopes), Save the Children International, and the Australian Government’s Department of Foreign Affairs and Trade (DFAT). Since its start in August 2013, PSL has supported all seven components of the MoH’s 2016-2020 Fast Track Initiative Road Map to Reduce Maternal and Newborn Mortality (FTIRM): emergency obstetric and newborn care, skilled birth attendance, newborn care, family planning, safe abortion (through training and quality improvement), behaviour change communication, and removing financial barriers.

The objectives of the endline were firstly to assess changes in the knowledge, attitudes and practices (KAP) of female garment factory workers (GFW) towards reproductive, maternal and neonatal health (RMNH) from the baseline indicators in the Monitoring, Evaluation, Reporting and Improvement (MERI) framework. Secondly, to determine the exposure and participation of garment factory workers (GFW) in the BCC and Chat! Contraceptive campaign activities, and any effects on MERI indicators, and lastly to gather qualitative information about the effectiveness of PSL in achieving its objectives and outcomes.

After successful completion of the midline survey, Angkor Research was awarded the contract to conduct the endline. Activities included all aspects of the endline survey design and implementation, including review of the research methodology and survey results from the baseline and midline, questionnaire review, translation and pre-testing, NECHR approval, field staff recruitment and training, CAPI system programming and testing, data collection, data management and quality control, data analysis, reporting and presentation of results. A total of 911 female garment factory workers of reproductive age were interviewed in four garment factories in Phnom Penh, representing nearly 10,000 workers; the response rate was 88.2%. 13 IDIs and 4 FGDs were also conducted with respondents from the quantitative survey. Indicators were disaggregated by various sub-groups and compared with the results from the baseline and midline to understand any changes in MERI indicators before and after the PSL intervention.

Biodigester Verification Survey Team

Local Monitoring of Project Implementation Activities

Impact Evaluation of the Voice and Action: Social Accountability for Improved Service Delivery (ISAF) Project: Endline Survey

GERES – Final Impact Evaluation

Impact study for agriculture interventions Mekong Inclusive Growth and Innovation Programme (MIGIP)

Assessment of the impact of smoke free village campaign

Consultancy for the comprehensive study on the debt environment in Cambodia for the Integrated Covid-19 response