Service Availability and Readiness Assessment (SARA) United Republic of Tanzania 2012
United Republic of Tanzania, 2012
Reference ID
TZA-MOHSW-SARA-2012-vFINAL
Producer(s)
Ministry of Health and Social Welfare
Created on
Jan 24, 2022
Last modified
May 23, 2022
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Identification
Survey ID Number
TZA-MOHSW-SARA-2012-vFINAL
Title
Service Availability and Readiness Assessment (SARA) United Republic of Tanzania 2012
Country
| Name | Country code |
|---|---|
| United Republic of Tanzania | TZA |
Study type
Service Availability and Readiness Assessment [hfa/sara]
Abstract
The Ministry of Health and Social Welfare in collaboration with WHO implemented the 2012 Service Availability and Readiness Assessment (SARA) for Tanzania. The survey was conducted by Ifakara Health Institute (IHI) in three rounds from May to December 2012. 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 family planning, child health services, basic and comprehensive obstetric care, HIV/AIDS, tuberculosis, malaria and noncommunicable diseases.
The survey was conducted in a nationally-representative sample of 27 districts, with a target sample of 1,908 health facilities and a final sample of 1,297 health facilities, representing more than 18% of all health facilities in the country. The sample comprised non-government as well as government health facilities and results were stratified by facility level, operating authority, ownership and urban/rural areas.
This report provides an important insight into service availability and readiness – both for health care in general and for a range of specific services. Further, the report covers three categories of indicators:
1. Service availability
• Health infrastructure
• Health workforce
2. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential tracer medicines
3. Service specific availability and readiness
• Family planning services
• Delivery services (normal delivery and basic emergency obstetric care)
• Routine child immunization
• Preventive and curative services for children under five years of age
• Adolescent health services
• Malaria services
• Tuberculosis diagnosis and treatment
• 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 infections services
• Diabetes services
• Cardiovascular disease services
• Chronic respiratory disease management
• Basic surgical services
• Advanced delivery
• Blood transfusion services
The survey was conducted in a nationally-representative sample of 27 districts, with a target sample of 1,908 health facilities and a final sample of 1,297 health facilities, representing more than 18% of all health facilities in the country. The sample comprised non-government as well as government health facilities and results were stratified by facility level, operating authority, ownership and urban/rural areas.
This report provides an important insight into service availability and readiness – both for health care in general and for a range of specific services. Further, the report covers three categories of indicators:
1. Service availability
• Health infrastructure
• Health workforce
2. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential tracer medicines
3. Service specific availability and readiness
• Family planning services
• Delivery services (normal delivery and basic emergency obstetric care)
• Routine child immunization
• Preventive and curative services for children under five years of age
• Adolescent health services
• Malaria services
• Tuberculosis diagnosis and treatment
• 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 infections services
• Diabetes services
• Cardiovascular disease services
• Chronic respiratory disease management
• Basic surgical services
• Advanced delivery
• Blood transfusion services
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities and district health offices
Version
Version Description
vFINAL: Final report, revised from first draft
Version Date
2013-07-01
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 district level
Universe
The survey covered 1,297 health facilities in 27 districts.
Producers and sponsors
Primary investigators
| Name |
|---|
| Ministry of Health and Social Welfare |
Producers
| Name | Role |
|---|---|
| Ifakara Health Institute | conducted the survey, analysed the data and prepared the report for publication. |
| World Health Organization | Technical support |
Funding Agency/Sponsor
| Name | Role |
|---|---|
| Global Fund to fight AIDS, Tuberculosis, and Malaria | Financial support |
Sampling
Sampling Procedure
The sample for this survey comprised all districts in the Sentinel Panel of Districts (SPD). This is a panel of 23 districts, plus an additional four districts where demographic sentinel surveillance systems are in operation (Rufiji, Kilombero, Ulanga, Kigoma Urban). The SPD district sampling was conducted by the National Bureau of Statistics using a two-stage, population-weighted probability sample to assure a nationally representative sample of districts that also permitted stratification by zone and by urban/rural area.
Deviations from the Sample Design
The targeted sample was 1908 health facilities which was reduced to 1297 health facilities. This was because of large number of facilities in some districts and highly dispersed (difficult to reach) facilities.
Response Rate
68%
Weighting
Sampling weights at first stage were calculated as a reciprocal of the probability of a district to be included in SAVVY sample. Since all health facilities in selected districts had equal chances of being included, no sampling weights were incorporated at second stage.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2012-05-01 | 2012-12-31 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
A three days training of data collectors was conducted. A district team comprising of two data collectors. Visited health facilities and administered data collection questionnaires to respective facility in-charges or the person responsible for respective specific services. Supervisors from the MOHSW and IHI went to all districts to provide supervision and reviewed data collection for completeness and quality.
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 SARA survey in Tanzania focused on the following modules:
1. Services available
2. Staffing
3. Service utilisation
4. Infrastructure
5. Available services
6. Infection control precautions
7. Family planning
8. Antenatal
9. PMTCT
10. Obstetric & newborn
11. Child immunisation
12. Child preventative & curative care
13. Adolescent health
14. HIV counselling & testing
15. HIV treatment
16. HIV care & support
17. Sexually transmitted infections
18. Tuberculosis services
19. Malaria services
20. Non-communicable disease services
21. Surgical services
22. Blood transfusion
23. Diagnostics
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 SARA survey in Tanzania focused on the following modules:
1. Services available
2. Staffing
3. Service utilisation
4. Infrastructure
5. Available services
6. Infection control precautions
7. Family planning
8. Antenatal
9. PMTCT
10. Obstetric & newborn
11. Child immunisation
12. Child preventative & curative care
13. Adolescent health
14. HIV counselling & testing
15. HIV treatment
16. HIV care & support
17. Sexually transmitted infections
18. Tuberculosis services
19. Malaria services
20. Non-communicable disease services
21. Surgical services
22. Blood transfusion
23. Diagnostics
Data Processing
Data Editing
Data cleaning was performed using SQL management studio.
Metadata production
DDI Document ID
DDI-TZA-SARA-2012-vFINAL
Producers
| Name | Abbreviation | Role |
|---|---|---|
| World Health Organization | WHO | Documentation of assessment |
Date of Metadata Production
2021-11-15
DDI Document version
DDI-TZ-SARA-2012-v02