Service Availability and Readiness Assessment (SARA) Sri Lanka 2017
Sri Lanka, 2017
Reference ID
LKA-MOHNIM-SARA-2017-vFINAL
Producer(s)
Ministry of Health, Nutrition and Indigenous Medicine, Department of Census and Statistics
Created on
May 30, 2022
Last modified
May 30, 2022
Page views
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Identification
Survey ID Number
LKA-MOHNIM-SARA-2017-vFINAL
Title
Service Availability and Readiness Assessment (SARA) Sri Lanka 2017
Country
| Name | Country code |
|---|---|
| Sri Lanka | LKA |
Study type
Service Availability and Readiness Assessment [hfa/sara]
Abstract
The Ministry of Health, Nutrition and Indigenous Medicine in collaboration with the Department of Census and Statistics implemented the 2017 Service Availability and Readiness Assessment (SARA) for Sri Lanka. The objective of the survey was to generate reliable and regular information on service delivery including service availability, such as the availability of key human and infrastructure resources, and on the readiness of health facilities to provide basic health-care interventions relating to maternal and child health services, basic and comprehensive obstetric care, HIV/AIDS, tuberculosis, malaria and non-communicable diseases.
The SARA 2017 was conducted in a nationally representative sample of 755 facilities drawn from a population of 2543 health facilities in Sri Lanka. Data was collected between June and July 2017.
This report covers the following categories of indicators:
1. General service availability and readiness
• Basic amenities
• Length of operation hours
• Basic and emergency equipment
• Standard precautions for infection control
• Diagnostic capacity
• Essential medicines
• Surgical management services
• Blood transfusion services
2. Service specific availability and readiness
• Maternal and child health
• HIV/AIDS
• Tuberculosis diagnosis and treatment
• Malaria services
• Rabies
• Dengue
• Chronic non-communicable diseases
• Sexually-transmitted infections
• Diabetes services
• Cardiovascular disease services
• Chronic obstructive pulmonary disease (COPD)
• Chronic kidney disease
• Cancer
• Mental health
• Care for the elderly
• Disability care
The SARA 2017 was conducted in a nationally representative sample of 755 facilities drawn from a population of 2543 health facilities in Sri Lanka. Data was collected between June and July 2017.
This report covers the following categories of indicators:
1. General service availability and readiness
• Basic amenities
• Length of operation hours
• Basic and emergency equipment
• Standard precautions for infection control
• Diagnostic capacity
• Essential medicines
• Surgical management services
• Blood transfusion services
2. Service specific availability and readiness
• Maternal and child health
• HIV/AIDS
• Tuberculosis diagnosis and treatment
• Malaria services
• Rabies
• Dengue
• Chronic non-communicable diseases
• Sexually-transmitted infections
• Diabetes services
• Cardiovascular disease services
• Chronic obstructive pulmonary disease (COPD)
• Chronic kidney disease
• Cancer
• Mental health
• Care for the elderly
• Disability care
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities
Version
Version Description
vFINAL: Final report
Version Date
2018-01-08
Scope
Notes
The SARA survey is designed to generate a set of core indicators on key inputs and outputs of the health system, which can be used to measure progress in health system strengthening over time. The SARA focuses on three main areas: service availability, general service readiness and service-specific readiness.
A basic approach to SARA is to collect data that are comparable both across countries and within countries (i.e. across regions and/or districts) using a standard core questionnaire developed by WHO in collaboration with the United States Agency for International Development (USAID). Usually, a country adopts the standard core questionnaire with adaptations to certain elements such as types of facilities, managing authority of facilities, national guidelines for services, staffing categories and national policies for medicines (e.g. for tuberculosis, HIV/AIDS). The SARA survey requires visits to health facilities with data collection based on key informant interviews and observation of key items. The survey can either be carried out as a sample or a census; the choice between these methodologies will depend on a number of elements including the country's resources, the objectives of the survey and the availability of a master facility list (MFL).
A basic approach to SARA is to collect data that are comparable both across countries and within countries (i.e. across regions and/or districts) using a standard core questionnaire developed by WHO in collaboration with the United States Agency for International Development (USAID). Usually, a country adopts the standard core questionnaire with adaptations to certain elements such as types of facilities, managing authority of facilities, national guidelines for services, staffing categories and national policies for medicines (e.g. for tuberculosis, HIV/AIDS). The SARA survey requires visits to health facilities with data collection based on key informant interviews and observation of key items. The survey can either be carried out as a sample or a census; the choice between these methodologies will depend on a number of elements including the country's resources, the objectives of the survey and the availability of a master facility list (MFL).
Coverage
Geographic Coverage
Nationally representative, as well as representative at sub-national level
Universe
The survey covered 755 health facilities including 41 tertiary care hospitals, 50 secondary care hospitals, 252 primary health care facilities, 344 public clinics and 68 privately owned hospitals.
Producers and sponsors
Primary investigators
| Name |
|---|
| Ministry of Health, Nutrition and Indigenous Medicine |
| Department of Census and Statistics |
Producers
| Name | Role |
|---|---|
| World Health Organization | Technical assistance |
Funding Agency/Sponsor
| Name | Role |
|---|---|
| Global Fund to fight AIDS, Tuberculosis, and Malaria | Financial support |
Sampling
Sampling Procedure
The sampling process adopted a two stage stratified random sampling technique with probability proportion to the size representing all facility types and districts. The first stratification was done based on facility type, and the second stratification was done taking into consideration the geographic variation within the country covering all 26 health districts. The strata according to facility type were: (i) primary health care facilities (primary medical care units and divisional hospitals); (ii) secondary health care institutions (Base Hospitals); (iii) tertiary health care institutions (District General Hospitals, Provincial General Hospitals, National Hospital of Sri Lanka and other Teaching Hospitals); (iv) public clinics (TB clinics, sexually transmitted disease (STD) clinics, Regional Malaria Offices (RMO), clinics at Medical Officer of Health (MOH), and Healthy Lifestyle Centres (HLC)); and (v) privately owned hospitals with in-patient services.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2017-06-01 | 2017-07-31 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
Modified SARA data collection tools were pretested among 10 health facilities in the Western province representing all types of health facilities considered in the survey. Appropriate revisions were done following the pretest.
Data were collected by a team of enumerators led by a medical officer and 2 statistical officers from the Department of Census and Statistics with past experience in health surveys. The survey team was trained and provided with a manual for data collectors prior to data collection. Data collection was facilitated by the district coordinators appointed in every health district to liaise with health facilities and the data collection teams.
Data were collected by a team of enumerators led by a medical officer and 2 statistical officers from the Department of Census and Statistics with past experience in health surveys. The survey team was trained and provided with a manual for data collectors prior to data collection. Data collection was facilitated by the district coordinators appointed in every health district to liaise with health facilities and the data collection teams.
Questionnaires
Questionnaires
The SARA core questionnaires overview:
Section 1: Cover page
Section 2: Staffing
Section 3: Inpatient and observation beds
Section 4: Infrastructure
Section 5: Available services
Section 6: Diagnostics
Section 7: Medicines and commodities
Section 8: Interviewers observations.
The WHO SARA tool was adapted to Sri Lanka's specific settings. The following modules were added to the questionnaire: dengue, rabies, breast cancer, oral cancer, chronic kidney disease, mental health, elderly care, disability care and gender based violence care.The modules on supervision and supply chain were excluded since they were beyond the scope of the survey.
Section 1: Cover page
Section 2: Staffing
Section 3: Inpatient and observation beds
Section 4: Infrastructure
Section 5: Available services
Section 6: Diagnostics
Section 7: Medicines and commodities
Section 8: Interviewers observations.
The WHO SARA tool was adapted to Sri Lanka's specific settings. The following modules were added to the questionnaire: dengue, rabies, breast cancer, oral cancer, chronic kidney disease, mental health, elderly care, disability care and gender based violence care.The modules on supervision and supply chain were excluded since they were beyond the scope of the survey.
Data Processing
Data Editing
Data were entered by a team of experienced data entry operators into a database developed using CSPro programme by the Department of Census and Statistics. Quality of data was assured through appropriate validity checks and data cleaning under supervision of the quality assurance team.
Access policy
Citation requirements
Ministry of Health, Nutrition and Indigenous Medicine and Department of Census and Statistics, 2018. Service Availability and Readiness Assessment 2017 Sri Lanka.
Metadata production
DDI Document ID
DDI-LKA-MOHNIM-SARA-2017-vFINAL
Producers
| Name | Abbreviation | Role |
|---|---|---|
| World Health Organization | WHO | Documentation of assessment |
Date of Metadata Production
2021-11-15
DDI Document version
Final version (report)