239736 Assessing readiness to provide services in health facilities: Examples of different methods providing different results

Tuesday, November 1, 2011

Nancy Fronczak, PhD , Social Sectors Development Strategies, Inc./International Health Facility Assessment Network (IHFAN), Mclean, VA
Paul Ametepi, MD , MEASURE DHS, ICF Macro, Calverton, MD
In the context of health systems where there is not universal accreditation or certification for health facilities, health facility assessments (HFA) are increasingly being used to assess programs and to evaluate readiness to provide health services. Unlike household surveys, however, consensus on “best practices” in methodology for conducting HFA does not exist. Differences in methods include a) using differing methods of data collection—some by interviewing a senior person and others validating responses by observation, b) using one response to represent the situation within a total facility c) assessing different service areas independently, and d) using different definitions for the same indicator. Finally, within the public sector, there is usually a theoretical criteria for classifying facilities (hospital, health center (or lower level)), while private sector facilities may be classified using no discernable criteria. The lack of clarity in facility clarification in the private sector, and differences between the theoretical criteria and reality in the public sector, result in facilities that differ hugely in magnitude of size and services being lumped together during analysis.

Data relevant to infection control, from nationally representative Service Provision Assessments (SPAs) conducted with ICF Macro technical support in Tanzania, Uganda, and Kenya will be used to demonstrate how the picture of readiness to provide services within facilities and the profile of facility conditions differs depending on where and how data are collected, and how facilities are classified for analysis. Infection control indicators will be the primary focus.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Program planning

Learning Objectives:
1. Demonstrate differences in assessments of facility readiness to provide services depending on where in the facility information is collected. 2. Describe methodological issues in facility-based data collection and analyses that influence interpretation of results. 3. Compare findings between 3 Sub-Sahara countries (Kenya, Tanzania, Uganda)

Keywords: Health Information Systems, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct health facility assessments and was instrumental in setting up the surveys from which the data for this presentation is based.
Any relevant financial relationships? No

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.