163079 Using Health Facility Assessment data to Improve Health Policy and Program at the National Level

Tuesday, November 6, 2007

Alfredo L. Fort, MD, PhD , Demographic and Health Surveys (DHS), Path/Macro International, Calverton, MD
Nancy Fronczak, PhD , Social Sectors Development Strategies, Inc., Mclean, VA
Laurie Liskin , Demographic and Health Surveys, Johns Hopkins University, Calverton, MD
Gulnara Semenov , Demographic and Health Surveys, Macro International, Calverton, MD
Rathavuth Hong, DrPH , MEASURE DHS, ORC Macro, Calverton, MD
Paul Ametepi , MEASURE DHS, ORC Macro, Calverton, MD
Since the first Service Provision Assessment (SPA) survey was implemented in 1998, demand for this survey has steadily increased. The Demographic and Health Survey (DHS) project has completed SPAs in 9 countries, and more surveys are on the way.

The SPA is nationally representative and provides a picture of the strengths and weaknesses of a country's public and private health care delivery systems. SPAs assess basic infrastructure, maternal and child health, family planning, infectious disease and HIV/AIDS services.

Countries are using the SPA as crucial information to derive policies for improvement of health services.

In Kenya, the 2004 SPA results helped shape the design of both the Second National Health Sector Strategic Plan (2005-2010) and the National AIDS Coordinating Project's annual strategic plan. DHS staff members in February/March 2006 gave 9 presentations to national and international program officers and officials. Several other donors, DfID and UNICEF, covered the costs of provincial level dissemination because of the keen interest nationwide. More workshops are being requested.

The Kenya SPA found a rate of basic Emergency Obstetric Care (EmOC) of 2.7 per 500,000 population, below the recommended standard of 4 per 500,000. These UN Process Indicators figures and their break-down by provinces are being used to upgrade health facilities to comply with international Safe Motherhood norms.

Similarly, in Zambia, USAID has requested additional dissemination of the Zambia HIV SPA to high level stakeholders in the MOH and policymakers including the staff at University Teaching Hospital and the Church Medical Association of Zambia.

In Tanzania, responding to specific malaria initiative needs, DHS is preparing a special series of tables on malaria services for the 2005 TSPA final report.

Other similar examples can be found for Ghana and Egypt. Recognition of the SPA's value is also growing in the international development community. DHS is receiving increasing numbers of requests for SPA datasets from researchers, doctoral students and faculty staff.

Learning Objectives:
Know what a Service Provision Assessment is, and its potential to evaluate the status and quality of care in a country. See examples of countries that have used the SPA to gain more knowledge of needs and improve specific health services.

Keywords: Health Assessment, Health Service

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.