Service: Monitoring and Evaluation (M&E)

HEF Utilisation Survey: Complementary Survey
(Evaluation of the Impact and Efficiency of the Integrated Social Health Protection Scheme in Cambodia: Follow-up Survey)

Location

Cambodia. Location within country: 3 provinces (Battambang, Kampong Cham, Kampong Thom)

Project Description

In 2013, the German-Cambodian Social Health Protection Project (SHPP) implemented by GIZ commissioned a survey to gather evidence on the effectiveness and efficiency of integrated social health protection schemes (ISHPS) for the poor on the utilisation of health services and associated financial protection, in four GIZ-supported operational districts (ODs). A first round of data collection was conducted between November 2013 and March 2014, with a second round planned for 2014-2015. Due to the similar objectives of this survey with the WB-initiated HEF Utilization Survey, GIZ and WB agreed to cooperate on producing similar instruments, sampling, data collection and analysis for the two studies, fielded simultaneously in 2015. It thus enabled a comparison of these GIZ-supported schemes with other HEFs in Cambodia, as well as the initial baseline.

After winning the public bid for the HEF Utilization Survey, Angkor Research was awarded the contract for the Complementary Survey from GIZ. Angkor Research was responsible for all components of the data collection and data management, including: initial research design and literature review; sampling methodology, framework and selection (including longitudinal matching of baseline households); instrument design, translation and pre-testing; national ethical approval (NECHR); field data collection; data entry and data management; transcription, translation and coding of all qualitative data; quantitative and qualitative data analysis; and report writing.

The Complementary Survey was also longitudinal, with tracking and follow-up interviews with baseline respondents. The quantitative household survey was conducted with 1,889 households, with a two-tiered control arm, and segregated by distance to the nearest public health facilities. Care was taken to ensure alignment of all survey instruments and sampling procedures between the two projects, and with the previous baseline survey. Additional qualitative in-depth interviews (IDIs) were conducted with 56 key informants including ISHP members, HEF operators, public hospital/health center directors and doctors, and village health support group volunteers. The quantitative household survey was conducted among 1,745 households, including 1,521 households matched from the baseline. The response rate was 92.4%, and individual interviewers completed an average of 5.8 interviews per day.

Survey Supervision and Quality Assurance: Health Markets and Utilization Survey and Cambodia Medical Worker’s Professional Development Survey

Location

Cambodia. Location within country: Phnom Penh and 9 provinces (Banteay Meanchey, Kampong Cham, Kampong Speu, Kampot, Preah Vihear, Prey Veng, Siem Reap, Takeo and Kampong Thom)

Project Description

The main purpose of this assignment was to provide independent supervision and quality assurance for two World Bank surveys being fielded in Cambodia by third-party consultants as part of the 2nd Health Sector Support Program (HSSP2). The 2011 Cambodia Medical Worker’s Professional Development Survey was a labour market survey for health medical professionals in public, private, and non-profit sectors to inform decision making regarding appropriate compensation policies and incentives for health medical workers in the public sector. The study improved understanding of health worker motivation and how different financing schemes impact compensation, motivation, work hours and private practice.

The survey was conducted in 19 operational districts (ODs) with a sample of 1,000 health professionals. The Health Markets and Utilization Survey was conducted to measure the prices, distances, and market shares associated with health care providers, and to measure health and health seeking behavior in the households that they tend, in order to describe the structure of health care markets and inform government and donor programs that seek to improve the quality of care in Cambodia. The survey was conducted in 8 ODs with a sample of approximately 2,000 households and 1,000 health providers.

Staff of Angkor Research conducted all aspects of the quality control procedures for both surveys, including:

  • Collaboration with implementing agencies in the field to supervise and implement quality control procedures for data collection. This involved oversight of sampling applications, interview observations, and
  • Re-interviews with 5% of total samples for each survey and respondent type (households and health facilities);
  • Verification of proper implementation of field supervision and quality control protocols by the implementing agencies;
  • Verification of data entry accuracy and database maintenance procedures via a random check of 5% of entered data;
  • Real-time collaboration and feedback to implementing firms to improve implementation & data quality as required.

Outputs for this project included bi-weekly progress reports throughout the course of the project (oversight of data collection and data entry activities), re-interviews with approximately 100 medical professionals and 100 household respondents, and entry of approximately 200 questionnaires for data entry verification. Re-interviews were conducted face-to-face and by telephone when necessary.

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