Service Availability and Readiness Assessment (SARA) Ethiopia 2018
Ethiopia, 2017
Reference ID
ET-EPHI-SARA-2018-vFINAL
Producer(s)
Ethiopian Public Health Institute (EPHI), Ministry of Health
Created on
Jan 12, 2022
Last modified
May 23, 2022
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Identification
Survey ID Number
ET-EPHI-SARA-2018-vFINAL
Title
Service Availability and Readiness Assessment (SARA) Ethiopia 2018
Country
| Name | Country code |
|---|---|
| Ethiopia | ET |
Study type
Service availability and readiness assessment [HFA/SARA]
Abstract
Ethiopian Public Health Institute in collaboration with the Federal Ministry of Health implemented the 2018 Service Availability and Readiness Assessment (SARA) for Ethiopia. SARA was conducted to assist the health sector in assessing and monitoring service readiness and capacity at region and health facility levels on a regular basis. The objective of the survey was to generate reliable and regular information on service delivery including service availability, such as the availability of diagnostic, essential medicines, and infrastructure resources, and on the readiness of health facilities to provide basic health-care interventions relating to maternal health, child health services, HIV/AIDS, tuberculosis, malaria and non-communicable diseases.
The survey covered 764 health facilities in 11 regions across the country.
The Ethiopia SARA 2018 report provides information on a set of tracer indicators of service availability and readiness in the following categories:
1. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential tracer medicines
2. Service specific availability and readiness
• Family planning
• Antenatal
• Basic Emergency and Essential Obstetric and Newborn care
• Comprehensive obstetric care Services
• Child immunization service
• Child preventive and curative care service
• Maternal, neonatal and child health
• Non-communicable diseases
• Adolescent health
• Malaria
• Tuberculosis
• HIV counselling and testing
• HIV/AIDS care and support
• Antiretroviral prescription and client management
• Prevention of mother-to-child transmission of HIV (PMTCT)
• Sexually-transmitted infection
• Neglected Tropical Disease (NTD)
• Public Health Emergency Management (PHEM) Services
• Surgery and blood transfusion
• Emergency
• Intensive Care Unit service
The survey covered 764 health facilities in 11 regions across the country.
The Ethiopia SARA 2018 report provides information on a set of tracer indicators of service availability and readiness in the following categories:
1. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential tracer medicines
2. Service specific availability and readiness
• Family planning
• Antenatal
• Basic Emergency and Essential Obstetric and Newborn care
• Comprehensive obstetric care Services
• Child immunization service
• Child preventive and curative care service
• Maternal, neonatal and child health
• Non-communicable diseases
• Adolescent health
• Malaria
• Tuberculosis
• HIV counselling and testing
• HIV/AIDS care and support
• Antiretroviral prescription and client management
• Prevention of mother-to-child transmission of HIV (PMTCT)
• Sexually-transmitted infection
• Neglected Tropical Disease (NTD)
• Public Health Emergency Management (PHEM) Services
• Surgery and blood transfusion
• Emergency
• Intensive Care Unit service
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities
Version
Version Description
v0.1: Final report
Version Date
2018-05-01
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 regional level.
Universe
The assessment covered 764 health facilities in 11 regions across the country.
Producers and sponsors
Primary investigators
| Name |
|---|
| Ethiopian Public Health Institute (EPHI) |
| Ministry of Health |
Producers
| Name | Role |
|---|---|
| World Health Organization | Technical assistance in questionnaire development, data collection, data processing, data analysis, and dissemination |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| World Bank | WB | Financial support |
Other Identifications/Acknowledgments
| Name | Affiliation | Role |
|---|---|---|
| Federal Ministry of Health | Government | Technical direction and support |
| Ethiopian Public Health Institute | Government | Implementation of SARA |
Sampling
Sampling Procedure
A nationally representative sample stratified by health facility type and managing authority. Sample size calculation took into account Ethiopian's skewed health facility distribution. A total of 764 health facilities were selected for the sample. Of these, 303 were hospitals, 164 were health centres, 165 were clinics and 132 were health posts.
Response Rate
100%
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2017-10-01 | 2017-12-29 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
A survey team of 89 people, mostly health providers (nurses, nurse midwives, and clinicians) were trained in the application of survey instruments and computer programmes. A pre-test for the survey took place before the start of the survey. Interviews were conducted in English and Amharigna using computer assisted personal interviewing–CAPI.
Questionnaires
Questionnaires
The SARA core instrument has three main areas of focus that included service availability, general service readiness and service specific readiness. The 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 core questionnaires are developed in English and are provided as external resources. The questionnaire was adapted to the country context and translated into Amharigna.
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 core questionnaires are developed in English and are provided as external resources. The questionnaire was adapted to the country context and translated into Amharigna.
Data Processing
Data Editing
The information entered in the PC-tablets by each interviewer was sent regularly to Ethiopian Public Health Institute (EPHI) central server by the team supervisor. These data files were concatenated, reviewed and checked for any errors and inconsistencies. Data cleaning included the checking of range, structure and a selected set of checks for internal consistency. All errors detected during machine editing were corrected. All data entry and editing programs were written using CSPro.
Access policy
Contacts
| Name | Affiliation | URL |
|---|---|---|
| Ethiopian Public Health Institute (EPHI) | Government | Link |
Metadata production
DDI Document ID
DDI-ET-SARA-2018-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)