Post Conflict Health Facility Assessment Libya 2012
Country
Name
Libya
Study type
Service Availability and Readiness Assessment [hfa/sara]
Abstract
The Ministry of Health in collaboration with World Health Organization - Regional Office for the Eastern Mediterranean implemented the 2012 Service Availability and Readiness Assessment (SARA). The SARA for Libya was conducted to: assess the current status of infrastructure, service delivery and system resources including human resources, supply-chain system, technologies and financial resources, assess facilities readiness and any damage which could have been sustained during the conflict, and measure system outputs, service utilization and their adequacy.
SARA Libya survey covered all primary health care (PHC) facilities from each of the 23 districts across the country. A total of 1379 primary health care facilities were included in the survey. Of these, 736 were primary health care units, 496 were primary health care centers and 147 were other types of primary facilities. Data was collected between February and April 2012.
This report covers the following categories of indicators:
1. General service availability
• Health infrastructure density
• Health workforce density
• Service utilization
2. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for prevention of infections
• Diagnostic capacity
• Essential medicines
• Laboratory equipment capacity
3. Service specific availability and readiness
• Antenatal care
• Basic obstetric care
• Child immunization
• Preventive and curative care for children under five
• Adolescents Health
• Preventing mother-to-child transmission of HIV (PMTCT)
• Diabetes
• Cardiovascular Diseases
• Blood Transfusion
• Basic Surgery
• School Health
• Oral Health
• Mental Health Care
• Cancer Diagnosis and Management
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities
Version
Version Description
Final report
Version Date
2012-12-02
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.
1. General service availability (accessibility of health services): health infrastructure (density of facilities and inpatient beds), core health personnel, and inpatient/outpatient services utilization
2. General service readiness (capacity of health facilities to provide general health services): presence of infrastructure/amenities, basic equipment, standard precautions for prevention of infections, laboratory diagnostic capacity, and essential medicines
3.Specific service availability and readiness (proportion of facilities providing specific key health interventions and their capacity to provide these services): availability of guidelines, trained staff, equipment, diagnostics, and medicines and commodities required to provide the services
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 district, facility, central and sub central levels.
Universe
The survey covered 1379 primary health facilities. Of these, 736 were primary health care units, 496 were primary health care centers and 147 were other types of primary facilities.
Producers and sponsors
Primary investigators
Name
Ministry of Health
Producers
Name
Role
World Health Organization
Technical assistance
Sampling
Sampling Procedure
The 2012 Libya SARA was a census of all public primary health care facilities (PHC) in Libya. All public primary health care facilities (PHC) in Libya from each of the 23 district were included in the survey. It was decided that all facilities will be covered in this assessment as the impact of the conflict is expected to be uneven across the country.
Due to the absence of a comprehensive Master Facility List (MFL), a preliminary list of facilities was provided by Health Information Center on time. A total of 1402 facility were identified for the survey and contacted. Out of those 23 facilities were found to be general or specialized hospitals and were excluded during the analysis.
Data Collection
Dates of Data Collection
Start
End
2012-02-01
2012-04-30
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
The survey utilized the tools developed through SARA and modified them to Libya context. Training took place in Libya – Benghazi with a trainer expert from El-Zanaty who led the training with WHO/EMRO staff from 15–19 January 2012. The SARA tools was piloted in some health facilities. A total number of 26 staff from the District Health Offices were trained in data collection and 81 field staff as interviewing teams carried out the data collection between February and April 2012.
Questionnaires
Questionnaires
The survey utilized the tools developed through SARA and modified to Libya context. The SARA questionnaire consisted of a set of questions measuring service availability and readiness that can be used to detect change and measure progress in health system strengthening over time (Pre and Post conflict).
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