Design and implementation of the impact evaluation of the Cuidado em Casa integrated home care pilot

Description

The Inter-American Development Bank (IDB), in coordination with the National Secretariat for Care Policy (SNCF/MDS) and participating Brazilian municipalities (Colombo, Fortaleza, and Juazeiro), invites consulting firms to submit proposals to design and execute a methodologically rigorous impact evaluation, longitudinal process evaluation, and cost-effectiveness analysis for the Cuidado em Casa integrated home care pilot.

1. Methodological design & sampling strategy
Experimental & quasi-experimental framework: Design an RCT stratified by municipality using the older adult–family caregiver dyad as the unit of randomization, complemented by quasi-experimental approaches (e.g., staggered difference-in-differences) where randomization is operationally unfeasible.

Sample sizing & statistical power: Evaluate a reference sample of approximately 900 dyads (450 treatment and 450 comparison across three municipalities), establishing power calculations (minimum 80% power, 5% significance) to detect effects on primary outcomes.

Validated measurement tools: Pre-specify primary outcomes using instruments validated for the Brazilian population, including the Katz index (functional ability), Zarit scale (caregiver burden), PHQ-9 and GAD-7 (mental health), and WHOQOL-OLD (quality of life).

2. Data collection, administrative integration & process evaluation
Primary fieldwork & administrative data: Conduct primary field surveys (baseline and follow-up) while intensively leveraging secondary administrative data from health and social assistance systems (CadÚnico, SUAS/CRAS, SIH-SUS, e-SUS APS).

Longitudinal process evaluation: Analyze implementation fidelity, operational barriers, resource requirements, and intersectoral coordination mechanisms between the social assistance (SUAS) and health (SUS) systems.

Econometric analysis & validity controls: Estimate Intention-to-Treat (ITT) and Local Average Treatment Effect (LATE) impacts using ANCOVA models, testing for differential attrition (e.g., deaths, institutionalization) and crossover between groups.

3. Cost-effectiveness, policy briefs & knowledge dissemination
Economic evaluation: Conduct a cost-effectiveness analysis to evaluate the sustainability, resource needs, and operational conditions required to scale up the home care model nationally.

Policy deliverables & reporting: Produce technical reports, working papers, and policy briefs with results disaggregated by sex, race/color, age group, and territory to inform Brazil's National Care Policy.

Stakeholder workshops: Facilitate dissemination workshops and technical sessions with public officials, civil society representatives, and policymakers.

Note: Interested consulting firms must review the requirements on the BEO Bidders Portal.