Impact evaluation of the interrelated household and community health (Keneya Nieta) and the health systems strengthening, governance and financing (Keneya Sinsi Wale) activities in Mali

Last registered on November 30, 2022

Pre-Trial

Trial Information

General Information

Title
Impact evaluation of the interrelated household and community health (Keneya Nieta) and the health systems strengthening, governance and financing (Keneya Sinsi Wale) activities in Mali
RCT ID
AEARCTR-0010482
Initial registration date
November 27, 2022

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
November 30, 2022, 4:36 PM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Region

Primary Investigator

Affiliation
Results for Development

Other Primary Investigator(s)

Additional Trial Information

Status
On going
Start date
2022-03-31
End date
2024-06-30
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
The USAID/Mali Mission commissioned Results for Development (R4D) to conduct the impact evaluation of Keneya Sinsi Wale (KSW) and KN (Keneya Nieta) to measure the impact and sustainability of accountability, governance, and financing (AGF) interventions of KSW and KW at the ASACO and CSCOM level. The impact evaluation will address the following key question:

To what extent did investments in accountability, governance, and financing activities in Keneya Sinsi Wale and Keneya Nieta improve behaviors for health (including financing and governance behaviors) and use of services at community and health centers?

This evaluation will address whether improving local health systems leadership, governance, and accountability and reduced financial barriers to health services (KSW) and improving individuals, households and community financial management, planning and savings for health and increasing community engagement, ownership, and oversight of local health services (KN) will lead to a statistically significant improvement of key healthy behaviors and community financial management, planning and an increase of health savings behaviors for health at the village and household level.
External Link(s)

Registration Citation

Citation
Djimeu Wouabe , Eric . 2022. "Impact evaluation of the interrelated household and community health (Keneya Nieta) and the health systems strengthening, governance and financing (Keneya Sinsi Wale) activities in Mali." AEA RCT Registry. November 30. https://doi.org/10.1257/rct.10482-1.0
Sponsors & Partners

Sponsors

Partner

Experimental Details

Interventions

Intervention(s)
The accountability, governance, and financing intervention implemented at the health zones level by KSW include the following activities:
• Improving transparency in health service management and decision-making at community level
• Enhancing accountability mechanisms in place at community and district levels
• Improving health governance at district and regional levels
• Improving community-level health governance
• Contributing to evidence and learning for sustainable health financing strategies
• Improving financial management and budget implementation at regional, district, and local levels
• Improving transfer of resources from mayors’ offices to ASACO
• Improving community financial management systems

The accountability, governance, and financing intervention implemented at the villages level by KN include the following activities:

• Increasing financial literacy, financial planning, and use of savings for health at the individual, HH, and community levels
• Improving individual, HH, and community livelihood strategies and income management to generate resources for health
• Organizing communities to finance, and maintain local emergency transportation from HHs to health centers
• Provision by individuals, HHs and communities sustained financial and in-kind support to CHWs and community volunteers
• Improving community members’ understanding of the roles and responsibilities of the different actors in the health system, and their own roles and responsibilities in providing oversight and shaping the delivery of local health services
• Increasing community health leadership roles held by diverse people across the spectrum of gender, age, and roles in the community
• Ensuring the monitoring and supervision by community members of the health services and hold the service providers, the managers, and local elected officials responsible for the availability and quality of the health services and systems
• Increasing in the community health leadership positions occupied by various persons according to their sex, age, and role within the community
Intervention (Hidden)
Intervention Start Date
2022-04-04
Intervention End Date
2024-06-30

Primary Outcomes

Primary Outcomes (end points)
% of Children 12-23 months fully immunized (All vaccines appropriate for the age group)
% Children who receive Penta 3 by 12mo
Antenatal care coverage - at least four visits (%)
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The impact evaluation combines a cluster-randomized stepped wedge design and a traditional parallel cluster randomized control trial. The cluster randomized stepped wedge design for the AGF interventions implemented at health zones by KSW and a traditional parallel cluster randomized control trial design for the AGF interventions implemented at village level by KN. For the cluster randomized stepped wedge design, the health zones will receive the intervention in the staggered fashion spread over three years. For a traditional parallel cluster randomized control trial design for the AGF interventions implemented at village level by KN, we have two groups, a treatment group which will receive the intervention for at least two years and a comparison group which will not receive the intervention.
Experimental Design Details
Randomization Method
Randomization done in office by a computer
Randomization Unit
Health zone (Aire de santé)
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
84 health zones
Sample size: planned number of observations
84 health zones, 84 community health centers, 252 village health committees and 2,772 women and 2,772 children (12-23 months)
Sample size (or number of clusters) by treatment arms
42 health zones, 42 community health centers, 252 village health committees and 1386 women and 1386 children (12-23 months) by treatment arm
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
We have 86% statistical power to detect an increase of 10 percentage points of % of Children 12-23 months fully immunized (All vaccines appropriate for the age group)
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Sciences, Techniques and Technologies of Bamako (USTTB) at the University of Bamako
IRB Approval Date
2022-01-07
IRB Approval Number
2022/02/USTTB

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials