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Service Availability and Readiness Assessment | December 10, 20131 |
Service Availability and Readiness Assessment (SARA)
An annual system for monitoring service readiness
Kavitha ViswanathanDepartment of Health Statistics and Information System
Service Availability and Readiness Assessment (SARA)
An annual system for monitoring service readiness
Kavitha ViswanathanDepartment of Health Statistics and Information System
Service Availability and Readiness Assessment | December 10, 20132 |
Service Availability and Readiness and Data quality
Assessment: Approach
Service Availability and Readiness and Data quality
Assessment: Approach
� WHO and partners working on a set of tools to improve availability, quality and use /analysis of facility data
� Builds on experiences of SAM, SPA - other facility surveys and country
experiences
� Harmonized standard approach and toolkit for annual monitoring of
service delivery and data quality
• Fills critical data gaps in service delivery (availability and readiness including
information on private sector) – as a complement to the routine HMIS
• Provides objective verification of whether or not a facility meets a required
condition
• Objective and systematic approach to data quality ascertainment
�Strong links to country review and planning processes
Service Availability and Readiness Assessment | December 10, 20133 |
IHP+ M&E Results Chain Framework IHP+ M&E Results Chain Framework
Inputs & processes Outputs Outcomes Impact
Data
collection
Indicator
domains
Analysis &
synthesis
Communi-
cation & use
Improved
health outcomes
& equity
Social and financial
risk protection
Responsiveness
Fin
an
cin
g
Infrastructure
/ ICT
Health
workforce
Supply chain
Information
Intervention
access &
services
readiness
Intervention
quality, safety
and efficiency
Coverage of
interventions
Prevalence risk
behaviours &
factors
Go
ve
rna
nce
Administrative sourcesFinancial tracking system; NHA
Databases and records: HR,
infrastructure, medicines etc.
Policy data
Facility assessments Population-based surveysCoverage, health status, equity, risk protection, responsiveness
Facility reporting systemsService readiness, quality, coverage, health status
Vital registration
Data quality assessment; Estimates and projections; Use of research results;
Assessment of progress and performance; Evaluation
Targeted and comprehensive reporting; Regular country review processes; Global reporting
Service Availability and Readiness Assessment | December 10, 20134 |
Service Availability and Readiness and Data quality
Assessment: The Toolkit
Service Availability and Readiness and Data quality
Assessment: The Toolkit
Facility assessment methodology (indicators, data
collection instruments and analytical tools and outputs):
� Service availability = physical presence of facilities, staff, beds
� Service readiness = capacity to delivery services (trained staff
+guidelines, equipment, diagnostics, medicines & commodities)
� Data verification (record review) – facility visit to verify reliability
of monthly facility reports
� Data Quality report card – indicators, tools and methodology for
systematic assessment of facility data –based on desk review
Service Availability and Readiness Assessment | December 10, 20135 |
SARA & Data verification MethodologySARA & Data verification Methodology
� Census required for service availability (recommend every 5-10
years)
� Facility sampling :
– Usually – national sample ( ~150 health facilities )
– Stratified by type and managing authority (public/private)
– Oversampling or including all hospitals
– Random sample within strata → Margin of error of ~10%
� Electronic data collection (CSPro questionnaires + PDAs/Tablets)
� Automated analysis (Excel) for report
� Recommend annually (Average time = 5 -6 weeks; average cost
100k-150 k)
� Ideally conducted 2-3 months before a health sector review)
Service Availability and Readiness Assessment | December 10, 20136 |
(1) Service availability(1) Service availability
1. Infrastructure
– Facility density
– Inpatient bed density
– Maternity bed density
2. Workforce
– Core health worker density
3. Service utilization– Outpatient visits
– Inpatient visits (admission)
Service Availability and Readiness Assessment | December 10, 20137 |
Density of health facilities per 10,000 population,
and by management authority,15 districts, Tanzania
Density of health facilities per 10,000 population,
and by management authority,15 districts, Tanzania
•On average,
there are 1.5
facilities /10,000
population
•Global target: 2
•Ownership
varies
Service Availability and Readiness Assessment | December 10, 20138 |
Density of core health personnel,15 districts, Tanzania 2
•On average,
there are 7.2
core health
professionals
per 10 000
population.
•WHO target: 23
Service Availability and Readiness Assessment | December 10, 20139 |
2. General service readiness2. General service readiness
5 domains- Each domain requires a number of tracer items that capture different aspects of service delivery:
1. Basic amenities: mean % availability of 7 items (power, improved water source, room with privacy, adequate sanitation facilities, communication equipment, access to computer with internet, emergency transportation)
2. Basic equipment: mean % availability of 6 items (blood pressure apparatus, stethoscope, adult scale, child scale, thermometer, light source, neonatal bag and mask)
3. Standard precautions: mean % availability of 9 items ( safe final disposal of sharp, safe final disposal of infectious wastes, appropriate storage of sharps waste, of infectious water, disinfectant, single use disposable /auto-disable syringes, soap and running water or alcohol based hand rub, latex gloves, guidelines for standard precautions)
4. Diagnostic capacity: mean % availability of 8 tests on site with appropriate equipment (haemoglobin, blood glucose, malaria diagnostic capacity, urine dipstick for protein, urine dipstick for glucose, HIV diagnostic capacity, syphilis RDT and urine pregnancy test)
5. Essential medicines: mean % availability of 20 essential medicines
Service Availability and Readiness Assessment | December 10, 201310 |
61% 62%
79%
83%
47%
35%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
General servicereadiness index
Basic amenitiesmean score
Basic equipmentmean score
Standardprecautions mean
score
Diagnostics meanscore
Essential medicinesmean score
Index
2. General service readiness index score Uganda 2013 (n = 209)
•Overall facilities
have mean
readiness score
of 61%
•With lowest
readiness in the
medicines
domains (35%)
and diagnostic
capacity (47%)
Service Availability and Readiness Assessment | December 10, 201311 |
3. Service specific readiness3. Service specific readiness
� Family planning
� Antenatal care
� Basic and comprehensive emergency obstetric care
� Maternal & newborn care
� Child and adolescent health
� HIV/AIDS (VCT, Care and support, PMTCT, ART)
� Malaria
� Tuberculosis
� Non-communicable disease
� Basic and comprehensive surgical care
� Blood transfusion
"Readiness" to deliver services =
Trained staff +Guidelines + Equipment/supplies + Diagnostics + +Medicines/commodities
Service Availability and Readiness Assessment | December 10, 201312 |
ImmunizationImmunization
SERVICE AVAILABILITY
Health interventions offered by facilities
SERVICE READINESS
Tracer items for delivery of intervention
% of facilities offering routine child immunization services
% of facilities offering outreach services
• BCG immunization
• Polio immunization
• DTP-Hib-HepB immunization
• Measles immunization
• Rotavirus immunization*
• Pneumococcal immunization*
Availability of trained staff and guidelines:
• Guidelines for EPI
• Staff trained in EPI in the last two years
Availability and functionality of equipment:
• Cold box/vaccine carrier with ice packs
• Refrigerator (functioning)
• Sharps container
• Single-use syringes
• Continuous temperature monitoring device in
refrigerator
• Energy source and power supply
• Immunization cards
• Immunization tally sheets
Availability and validity of medicines and commodities:
• Available and valid (not expired and VVM not turned) on
day of assessment
• Stock out- Inability to give vaccine anytime in past three
due to unavailable stock)* If included in national immunization schedule
Service Availability and Readiness Assessment | December 10, 201313 |
Service Availability% of facilities offering routine child immunization services
Service Availability% of facilities offering routine child immunization services
Service Availability and Readiness Assessment | December 10, 201314 |
Uganda 2012% of facilities offering immunization with tracer items (N=84)
Uganda 2012% of facilities offering immunization with tracer items (N=84)
•% of facilities with
staff trained in EPI in
last 2 years – low
(34%)
•1/3 of facilities
have no refrigerator
•Stock outs in about
1/3 facilities
• Only 18% with all
basic items
•Mean availability of
items = 76%
Service Availability and Readiness Assessment | December 10, 201315 |
Service Readiness% of facilities offering immunization services with tracer items
Service Readiness% of facilities offering immunization services with tracer items
* Mean availability of 4 antigens
(BCG, OPV, DTP-Hib-HepB, measles)
** Overall scores for Zambia exclude
EPI guidelines and trained staff
Service Availability and Readiness Assessment | December 10, 201316 |
Basic emergency obstetric careBasic emergency obstetric care
SERVICE AVAILABILITY
Health interventions offered by facilities
SERVICE READINESS
Tracer items for delivery of intervention
% of facilities that offer basic obstetric care services• Parenteral administration of antibiotics
• Parenteral administration of oxytocic drug
• Parenteral administration of anticonvulsants
• Assisted vaginal delivery
• Manual removal of placenta
• Manual removal of retained products
• Neonatal resuscitation
• Basic emergency obstetric care
Availability of trained staff and guidelines:
• Guidelines for Integrated management of pregnancy and
childbirth (IMPAC)
• Staff trained in IMPAC in the past two years
Availability and functionality of equipment:
Availability and validity of medicines and commodities:
* If included in national immunization schedule
• Antibiotic eye ointment for
newborn
• Injectable uterotonic
• Injectable antibiotic
• Magnesium sulphate
(injectable)
• Diazepam (injectable)
• Skin disinfectant
• Intravenous solution with
infusion set
• Emergency transport
• Sterilization equipment
• Examination light
• Delivery pack
• Suction apparatus (mucus
extractor)
• Manual vacuum extractor
• Vacuum aspirator or D&C kit
• Neonatal bag and mask
• Delivery bed
• Partograph
• Gloves
• Blood pressure apparatus
Service Availability and Readiness Assessment | December 10, 201317 |
Service Availability Basic emergency obstetric care - Uganda
Service Availability Basic emergency obstetric care - Uganda
100%
100%
100%
100%
77%
100%
100%
100%
77%
99%
99%
99%
75%
76%
99%
97%
99%
58%
0% 20% 40% 60% 80% 100% 120%
Offers delivery services
Parenteral administration of antibiotics
Parenteral administration of oxytocic drugs
Parenteral administration of anti-convulsants
Assisted vaginal delivery
Manual removal of placenta
Manual removal of retained products
Neonatal resuscitation
Basic emergency obstetric care (BEmOC)*
National/regional referral hospital General hospital and HC IV
Service Availability and Readiness Assessment | December 10, 201318 |
Service ReadinessBasic emergency obstetric care - Uganda
Service ReadinessBasic emergency obstetric care - Uganda
0% 20% 40% 60% 80% 100% 120%
Guidelines for IMPAC
At least one staff trained in IMPAC
Emergency transport
Sterilization equipment
Examination light
Delivery pack
Suction apparatus
Manual vacuum extractor
Vacuum aspirator or D&C kit
Neonatal bag and mask
Delivery bed
Partograph
Gloves
Antibiotic eye ointment
Injectable uterotonic
Injectable antibiotic
Magnesium sulphate (injectable)
Diazepam (injectable)
Skin disinfectant
Intravenous solution with infusion set
Percent of facilities with all items
Mean availability of tracer items
National/regional referral hospital General hospital and HC IV
Service Availability and Readiness Assessment | December 10, 201319 |
Comprehensive emergency obstetric careComprehensive emergency obstetric care
SERVICE AVAILABILITY
Health interventions offered by facilities
SERVICE READINESS
Tracer items for delivery of intervention
% of facilities that offer comprehensive obstetric
care services
• Caesarean section• Blood transfusion
• Comprehensive emergency obstetric care
Availability of trained staff and guidelines:
• Guidelines for CEmOC
• Staff trained in CEmOC
• Staff trained in surgery
• Staff trained in anaesthesia
Availability and functionality of equipment:
• Anaesthesia equipment
• Incubator
Availability of Diagnostics
• Blood typing
• Cross match testing
Availability and validity of medicines and commodities
• Blood supply sufficiency
• Blood supply safety
Service Availability and Readiness Assessment | December 10, 201320 |
Service Availability Comprehensive emergency obstetric care - Uganda
Service Availability Comprehensive emergency obstetric care - Uganda
100%
100%
77%
11%
6%
5%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Caesarean section
Blood transfusion
CEmOC*
Percentage availability
National/regional referral hospitals Other health facilities
Service Availability and Readiness Assessment | December 10, 201321 |
Service ReadinessComprehensive emergency obstetric care - Uganda
Service ReadinessComprehensive emergency obstetric care - Uganda
100%
72%
63%
47%
34%
25%
51%
30%
28%
21%
0%
47%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Staff trained in anaesthesia
Staff trained in surgery
At least 1 trained staff CEmOC
Guidelines available CEmOC
Anaesthesia equipment
Incubator
Blood typing
Cross match testing
Blood supply safety
Blood supply sufficiency
Percent of facilities with all items
Mean availability of tracer items
Percentage availability
Staff and Guidelines Equipment Diagnostics Medicines and Commodities Readiness Score
Service Availability and Readiness Assessment | December 10, 201322 |
Basic surgeryBasic surgery
SERVICE AVAILABILITY
Health interventions offered by facilities
SERVICE READINESS
Tracer items for delivery of intervention
% of facilities that offer basic surgery
• Basic surgical services• Incision and drainage of abscesses
• Wound debridement• Acute burn management• Suturing
• Closed treatment of fracture• Cricothyroidotomy
• Male circumcision• Hydrocele reduction• Chest tube insertion
Availability of trained staff and guidelines:
• Guidelines for IMEESC
• Staff trained in IMEESC
Availability and functionality of equipment:
Availability and validity of medicines and commodities
• Oxygen
• Skin disinfectant
• Sutures (both absorbable and non-absorbable)
• Ketamine (injectable)
• Lidocaine (1% or 2% injectable)
• Needle holder
• Scalpel handle with blade
• Retractor
• Surgical scissors
• Suction apparatus
• Nasogastric tubes (10-16
FG)
• Tourniquet
• Adult and paediatric
resuscitators
Service Availability and Readiness Assessment | December 10, 201323 |
Service Availability Basic surgery - Uganda
Service Availability Basic surgery - Uganda
0% 20% 40% 60% 80% 100% 120%
Offers basic surgical services
Incision and drainage of abscesses
Wound debridement
Acute burn management
Suturing
Closed treatment of fracture
Cricothyroidotomy
Male circumcision
Hydrocele reduction
Chest tube insertion
Tracheostomy
National/regional referral hospital General hospital and HC IV
Service Availability and Readiness Assessment | December 10, 201324 |
Service Readiness Basic surgery - Uganda
Service Readiness Basic surgery - Uganda
0% 20% 40% 60% 80% 100% 120%
Guidelines available IMEESC*
At least 1 trained staff IMEESC*
Needle holder
Scalpel handle with blade
Retractor
Surgical scissors
Nasogastric tubes
Tourniquet
Adult and paediatric resuscitators
Suction apparatus
Oxygen
Skin disinfectant
Sutures
Ketamine (injectable)
Lidocaine (1% or 2% injectable)
Percent of facilities with all items
Mean availability of tracer items
National/regional referral hospital General hospital and HC IV
Service Availability and Readiness Assessment | December 10, 201325 |
Comprehensive surgeryComprehensive surgery
SERVICE AVAILABILITY
Health interventions offered by facilities
SERVICE READINESS
Tracer items for delivery of intervention
% of facilities that offer comprehensive surgery
Availability of trained staff and guidelines:
• Guidelines for IMEESC (WHO Integrated Management for
Essential and Emergency Care)
• Staff trained in IMEESC
• Staff trained in surgery
• Staff trained in anaesthesia
Availability and validity of medicines and commodities
Availability and functionality of equipment:
• Oxygen
• Anaesthesia equipment
• Spinal needle
• Suction apparatus
• Thiopental (powder)
• Suxamethonium bromide
(powder)
• Atropine (injectable)
• Diazepam (injectable)
• Halothane (inhalation)
• Bupivacaine (injectable)
• Lidocaine 5% (heavy spinal
solution)
• Epinephrine (injectable)
• Ephedrine (injectable)
• Comprehensive surgical
services
• Tracheostomy
• Tubal ligation
• Vasectomy
• Dilatation & Curettage
• Obstetric fistula repair
• Episiotomy
• Appendectomy
• Hernia repair
• Cystostomy
• Urethral stricture
dilatation
• Laparotomy
• Congenital hernia repair
• Neonatal surgery
• Cleft lip repair
• Contracture release
• Skin grafting
• Open treatment of
fracture
• Amputation
• Cataract surgery
Service Availability and Readiness Assessment | December 10, 201326 |
Service Availability Comprehensive surgery - Uganda
Service Availability Comprehensive surgery - Uganda
100%
100%
100%
100%
100%
100%
100%
92%
92%
92%
92%
92%
92%
85%
77%
77%
77%
69%
46%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Offers comprehensive surgical services
Tubal ligation
Dilatation and Curettage
Episiotomy
Appendectomy
Hernia repair
Laparotomy
Vasectomy
Congenital hernia repair
Skin grafting
Open treatment of fracture
Amputation
Cataract surgery
Cystostomy
Obstetric fistula repair
Urethral stricture dilatation
Neonatal surgery
Contracture release
Cleft lip repair
Percentage availability
Service Availability and Readiness Assessment | December 10, 201327 |
Service Readiness Comprehensive surgery - Uganda
Service Readiness Comprehensive surgery - Uganda
84%
84%
49%
29%
72%
47%
26%
99%
92%
87%
86%
63%
62%
43%
22%
21%
18%
4%
58%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Staff trained in surgery
Staff trained in anaesthesia
At least 1 trained staff IMEESC*
Guidelines available IMEESC*
Suction apparatus
Spinal needle
Anaesthesia equipment
Diazepam (injectable)
Epinephrine (injectable)
Atropine (injectable)
Oxygen
Lidocaine 5% (heavy spinal solution)
Bupivacaine (injectable)
Ephedrine (injectable)
Halothane (inhalation)
Thiopental (powder)
Suxamethonium bromide (powder)
Percent of facilities with all items
Mean availability of tracer items
Percentage availability
Staff and Guidelines Equipment Medicines and Commodities Readiness Score
Service Availability and Readiness Assessment | December 10, 201328 |
Equipment tracer itemsEquipment tracer items
Equipment index: tracer items that all health
facilities should have
Tracer items in hospital
• Adult scale
• Child scale
• Thermometer
• Stethoscope
• Blood pressure apparatus
• Light source
• Anaesthesia equipmento Anaesthesia machine to deliver aesthetic
gases and oxygen
o Tubings and connectors to connect to the
endotracheal tube
o Resuscitator bag and mask- adult and
paediatric
o Intubation set adult and paediatric:
(Oropharyangeal airway, endotracheal
tubes, laryngoscope, Magill’s forceps,
stylet)
• Oxygen (cylinder or concentrator)
• Spinal needle
• Suction apparatus
Service Availability and Readiness Assessment | December 10, 201329 |
Hospital equipmentHospital equipment
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Benin Burkina Faso Mauritania Uganda Zanzibar
Mean availability Anesthesia equipment (E29) Suction apparatus (E28) Spinal needle (E32)
Service Availability and Readiness Assessment | December 10, 201330 |
Hospital equipment (cont.)Hospital equipment (cont.)
Benin (n=44)Burkina Faso
(n=22)
Mauritania
(n=20)Uganda (n=13) Zanzibar (n=9)
(All hospitals)(All hospitals and
polyclinics)(All hospitals)
(National and
Referral Hospitals)(Hospitals only)
2013 2013 2013 2013 2012
Anesthesia
equipment18% 36% 26% 26% 33%
Spinal needle 93% 91% 89% 47% 100%
Suction apparatus 95% 100% 100% 72% 100%
Mean availability 69% 76% 72% 48% 78%
Service Availability and Readiness Assessment | December 10, 201331 |
Diagnostic capacityDiagnostic capacity
Diagnostic index: tracer items that all health
facilities should have
Lab capacity expected in hospitals
• Haemoglobin
• Blood glucose
• Malaria diagnostic capacity
• Urine dipstick – protein
• Urine dipstick – glucose
• HIV diagnostic capacity
• Syphilis rapid test
• Urine test for pregnancy
• Serum electrolytes
• Full blodd count with differential
• Blood typing (ABO and Rhesus) and cross
match (by anti-globulin or equivalent)
• Liver function test (ALT or other)
• Renal function test (serum creatinine
testing or other)
• CD4 count and percentage
• HIV antibody testing (ELISA)
• Syphilis serology
• Cryptococcal antigen
• Gram stain
• Urine microscopy testing
• CSF/body fluids counts
Service Availability and Readiness Assessment | December 10, 201332 |
Basic lab capacityBasic lab capacity
0%
20%
40%
60%
80%
100%
120%
Benin Burkina Faso Mauritania Uganda Uganda Zanzibar
Mean availability Haemoglobin Blood glucose Malaria diagnostic capacity Urine dipstick- protein
Urine dipstick- glucose HIV diagnostic capacity Syphilis rapid test Urine test for pregnancy
Service Availability and Readiness Assessment | December 10, 201333 |
Basic diagnostic capacity (cont.)Basic diagnostic capacity (cont.)
Benin
(n=44)
Burkina
Faso (n=22)
Mauritania
(n=20)
Uganda
(n=13)
Uganda
(n=34)
Zanzibar
(n=44)
(All
hospitals)
(All
hospitals
and
polyclinics)
(All
hospitals)
(National
and Referral
Hospitals)
(General
Hospitals
and HCIV
clinics)
(Hospitals
only)
2013 2013 2013 2013 2013 2012
Haemoglobin 52% 59% 55% 69% 86% 45%
Blood glucose 34% 18% 75% 100% 81% 48%
Malaria diagnostic capacity 100% 91% 85% 92% 100% 89%
Urine dipstick- protein 86% 64% 75% 92% 62% 73%
Urine dipstick- glucose 82% 73% 80% 92% 62% 66%
HIV diagnostic capacity 100% 91% 85% 100% 82% 84%
Syphilis rapid test 70% 77% 80% 54% 15% 48%
Urine test for pregnancy 63% 55% 75% 54% 95% 36%
Mean availability 73% 66% 76% 82% 82% 48%
Service Availability and Readiness Assessment | December 10, 201334 |
Advanced lab capacityAdvanced lab capacity
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Benin Burkina Faso Mauritania Uganda Zanzibar
Mean availability HIV antibody testing (ELISA) (D23) Cryptococcal antigen (D30)
Service Availability and Readiness Assessment | December 10, 201335 |
Advanced lab capacity (cont.)Advanced lab capacity (cont.)
Benin
(n=44)
Burkina Faso
(n=22)
Mauritania
(n=20)Uganda (n=13)
Zanzibar
(n=44)
(All
hospitals)
(All hospitals
and
polyclinics)
(All
hospitals)
(National and
Referral
Hospitals)
(Hospitals
only)
2013 2013 2013 2013 2012
CSF/body fluid counts 86% 68% 40% 100% 11%
Gram stain 91% 77% 20% 92% 33%
Full blood count with differential 68% 68% 70% 85% 22%
Blood typing and cross match 73% 55% 35% 85% 44%
Urine dipstick with microscopy . . 45% 85% 44%
Liver function test 73% 64% 55% 77% 33%
Renal function test 68% 64% 65% 77% 22%
CD4 count and percentage 39% 55% 20% 77% 33%
Serum electrolytes 54% 64% 45% 69% 11%
Syphilis serology 75% 73% 55% 69% 33%
Cryptococcal antigen 14% 27% 15% 54% 0%
HIV antibody testing (ELISA) 7% 9% 10% 0% 0%
Mean availability 59% 57% 39% 71% 23%
Service Availability and Readiness Assessment | December 10, 201336 |
High level diagnostic equipmentHigh level diagnostic equipment
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Benin Burkina Faso Mauritania Uganda Zanzibar
Mean availability X-ray (E33) Ultrasound (E35) CT scan (E36) ECG (E34)
Service Availability and Readiness Assessment | December 10, 201337 |
High level diagnostic equipment (cont.)High level diagnostic equipment (cont.)
Benin
(n=44)
Burkina Faso
(n=22)
Mauritania
(n=20)Uganda (n=13)
Zanzibar
(n=44)
(All
hospitals)
(All hospitals
and
polyclinics)
(All
hospitals)
(National and
Referral
Hospitals)
(Hospitals
only)
2013 2013 2013 2013 2012
X-ray 68% 91% 85% 85% 78%
Ultrasound 89% 95% 90% 77% 67%
ECG 43% 73% 70% 31% 44%
CT scan 7% 23% 20% 15% 0%
Mean availability 59% 57% 39% 71% 23%
Service Availability and Readiness Assessment | December 10, 201338 |
SARA-HSARA-H
� Expansion of the hospital component of SARA
� Proposed modules:
o Module 1: Overview, Services, Governance, Management Systems, Human
Resources, and Capacity
o Module 2: Emergency services, procedures, and surgical services
o Module 3: Delivery and inpatient services
o Module 4: Blood transfusion, diagnostics and pharmaceutical commodities
o Module 5: Infrastructure and support services
o Module 6: Facility information system and service statistics
Service Availability and Readiness Assessment | December 10, 201339 |
Next stepsNext steps
� Hospital census in Uganda in January 2014
� Hospital survey in Moldova in early 2014
� Revision of the hospital indicators in 2014
� Inclusion of the new hospital modules in subsequent SARAs
� Regionalization – basic minimum for low/middle income countries
Service Availability and Readiness Assessment | December 10, 201340 |
For further information, please contact: [email protected]
For further information, please contact: [email protected]
THANK YOU