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Community monitoring and nonfinancial award programs for health clinics in Sierra Leone improved clinic utilization, patient satisfaction, and reporting during the 2014 Ebola crisis. Community monitoring improved child health and reduced mortality among Ebola patients.

Key Results

Both community monitoring and nonfinancial awards for clinic staff increased patient satisfaction and health care utilization. On average, patients’ satisfaction with their care increased by 0.10 standard deviations relative to clinics in the comparison group. General health care utilization increased by 0.11 standard deviations on average.

Community monitoring also improved child health. Community monitoring led to 38 percent fewer deaths of children under age five. 

Improvements in the perceived quality of care increased reporting of Ebola symptoms and willingness to seek treatment during the epidemic. During the 2014 Ebola crisis, areas with program clinics increased reporting of Ebola cases—including patients that tested both positive and negative for the virus—by 62 percent relative to comparison areas.  

Similar to the pre-Ebola period, only community monitoring improved health outcomes during the Ebola crisis. Community monitoring reduced Ebola-related deaths from one patient death for every four Ebola cases to about one in ten.