Service Availability and Readiness Assessment Mapping (SARAM) Kenya 2013
Kenya, 2013
Reference ID
KEN-MOH-SARAM-2013-vFINAL
Producer(s)
Ministry of Health
Created on
Jan 12, 2022
Last modified
May 24, 2022
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Identification
Survey ID Number
KEN-MOH-SARAM-2013-vFINAL
Title
Service Availability and Readiness Assessment Mapping (SARAM) Kenya 2013
Country
| Name | Country code |
|---|---|
| Kenya | KEN |
Study type
Service Availability and Readiness Assessment Mapping Survey [HFA/SARAM]
Abstract
The Ministry of Health in collaboration with WHO implemented the 2013 Service Availability and Readiness Assessment Mapping (SARAM) for Kenya. The SARAM was a national census involving all units involved in health including health facilities (public and private), and management levels in Kenya that was carried out between April and May 2013. The SARAM survey was designed with an aim to provide an understanding of the capacity for service provision across counties in Kenya. Its objective is to generate reliable information on service delivery, availability of basic inputs to provide different services, and on the readiness of health facilities to provide basic health-care interventions. It provides a mapping of: (i) status of Kenya Essential Package for Health (KEPH) provision across the Country (health outcomes), (ii) capacity to provide services with a focus on availability of critical inputs needed for provision of services and functionality of critical inputs needed for provision of services, and (iii) readiness of critical inputs needed for provision of services.
A standard set of data was collected from each facility and management unit based on a pre-designed questionnaire that collected three sets of information:
(i) Basic information: Location, ownership, geocodes;
(ii) Service availability: Service interventions provided by the facility, and available human resources for health (HRH), infrastructure (physical, equipment and communication) and health products to facilitate provision of the interventions; and
(iii) Service readiness: Health service delivery organization, and leadership capacity needed to provide the services.
This report covers the following categories of indicators:
1. General service availability
• Health infrastructure
• Health workforce
• Service utilization
2. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential medicines
3. Service specific availability and readiness
• HIV/AIDS
• Tuberculosis
• Non-communicable diseases
• Malaria
• Maternal and child health
• HIV counselling and testing
• HIV/AIDS care and support
• Antiretroviral prescription and client management
• Prevention of mother-to-child transmission of HIV (PMTCT)
• Surgical services
4. Health leadership and partnership readiness
• Service delivery organization readiness
• Health stewardship readiness
• Health partnership readiness
• Health governance readiness
A standard set of data was collected from each facility and management unit based on a pre-designed questionnaire that collected three sets of information:
(i) Basic information: Location, ownership, geocodes;
(ii) Service availability: Service interventions provided by the facility, and available human resources for health (HRH), infrastructure (physical, equipment and communication) and health products to facilitate provision of the interventions; and
(iii) Service readiness: Health service delivery organization, and leadership capacity needed to provide the services.
This report covers the following categories of indicators:
1. General service availability
• Health infrastructure
• Health workforce
• Service utilization
2. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential medicines
3. Service specific availability and readiness
• HIV/AIDS
• Tuberculosis
• Non-communicable diseases
• Malaria
• Maternal and child health
• HIV counselling and testing
• HIV/AIDS care and support
• Antiretroviral prescription and client management
• Prevention of mother-to-child transmission of HIV (PMTCT)
• Surgical services
4. Health leadership and partnership readiness
• Service delivery organization readiness
• Health stewardship readiness
• Health partnership readiness
• Health governance readiness
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities and health management units
Version
Version Description
vFINAL: Final report
Version Date
2014-01-06
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 zonal levels
Universe
The survey covered 8,401 health facilities in 10 country zones.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Ministry of Health | Government |
Producers
| Name | Role |
|---|---|
| World Health Organization | Technical guidance, analysis and financing report writing |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| Department for International Development | DFID | Financial support |
Sampling
Sampling Procedure
8,401 health facilities in 10 country zones were selected for the sample. The selected health facilities included public health facilities, private not-for-profit facilities and private-for-profit facilities.
Response Rate
88%
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2013-04-01 | 2013-05-30 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
Independent firms were contracted to coordinate data collection in each of the 10 zones of the country. A standard questionnaire was developed, and provided to each firm for use in data collection. The data collection process was automated through use of hand held devices/computers to enter the data from the field. A DHIS module was opened to facilitate this. A Quality Assurance team was constituted from national and county levels, involving both government and partner representatives. This team provided oversight to the independent firm during the data collection process, to ensure information was being collected as planned. Data verification was carried out during the field work as information was entered into the DHIS module by a national level dedicated team, and corrections required communicated to the field teams during data collection.
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 Kenyan national SARA coordinating committee adapted and reviewed the tool to include indicators on health leadership and partnership readiness. This adapted standard questionnaire was used to collect information on three core areas:
1. Basic facility information: Location, ownership, geocodes
2. Service Availability: Service interventions provided by the facility, and available human resources for health (HRH), infrastructure (physical, equipment and Communication) and health products to facilitate provision of the interventions
3. Service Readiness: Health service delivery organization, and leadership capacity needed to provide the health care service.
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 Kenyan national SARA coordinating committee adapted and reviewed the tool to include indicators on health leadership and partnership readiness. This adapted standard questionnaire was used to collect information on three core areas:
1. Basic facility information: Location, ownership, geocodes
2. Service Availability: Service interventions provided by the facility, and available human resources for health (HRH), infrastructure (physical, equipment and Communication) and health products to facilitate provision of the interventions
3. Service Readiness: Health service delivery organization, and leadership capacity needed to provide the health care service.
Access policy
Citation requirements
Government of Kenya, 2014: Kenya Service Availability and Readiness Assessment Mapping (SARAM). Ministry of Health, Nairobi Kenya
Metadata production
DDI Document ID
DDI-KEN-SARAM-2013-vFINAL
Producers
| Name | Abbreviation | Role |
|---|---|---|
| World Health Organization | WHO | Documentation of assessment |
Date of Metadata Production
2021-11-14
DDI Document version
Final version: report