Service Availability and Readiness Assessment (SARA) Ethiopia 2016
Ethiopia, 2016
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Reference ID
ETH-EPHI-SARA-2016-vFINAL
Producer(s)
Ethiopian Public Health Institute (EPHI), Ministry of Health, World Health Organization
Created on
Jan 24, 2022
Last modified
May 31, 2022
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Identification
Survey ID Number
ETH-EPHI-SARA-2016-vFINAL
Title
Service Availability and Readiness Assessment (SARA) Ethiopia 2016
Country
| Name | Country code |
|---|---|
| Ethiopia | ET |
Abstract
In 2016, Ethiopian Public Health Institute and the Ministry of Health collaborated with WHO to implement a survey on the 2016 Service Availability and Readiness Assessment (SARA). The survey 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 is 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 2016 Ethiopian SARA survey was a facility based cross sectional survey. A nationally representative sample of 705 health facilities was selected for the assessment, with an oversampling of hospitals. Of these, 228 were hospitals, 165 were health centres, 173 were clinics and 139 were health posts.
The findings from the assessment were stratified by facility type, region, managing authority, and urban/rural areas of the facility. This report covers the following categories of indicators:
1. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential medicines
2. Service specific availability and readiness
• Maternal health
• Basic Emergency and Essential Obstetric and Newborn care (BEm/EONC)
• Family planning
• Antenatal
• Comprehensive obstetric care
• Non-communicable diseases (diabetes disease, cardiovascular, chronic respiratory disease and cervical cancer)
• Child and adolescent health
• Neglected tropical diseases
• HIV/AIDS
• Tuberculosis
• Malaria
• Sexually-transmitted infections
• Surgery and blood transfusion
• Public Health Emergency Management (PHEM) Services
The 2016 Ethiopian SARA survey was a facility based cross sectional survey. A nationally representative sample of 705 health facilities was selected for the assessment, with an oversampling of hospitals. Of these, 228 were hospitals, 165 were health centres, 173 were clinics and 139 were health posts.
The findings from the assessment were stratified by facility type, region, managing authority, and urban/rural areas of the facility. This report covers the following categories of indicators:
1. General service readiness
• Basic amenities
• Basic equipment
• Standard precautions for infection prevention
• Diagnostic capacity
• Essential medicines
2. Service specific availability and readiness
• Maternal health
• Basic Emergency and Essential Obstetric and Newborn care (BEm/EONC)
• Family planning
• Antenatal
• Comprehensive obstetric care
• Non-communicable diseases (diabetes disease, cardiovascular, chronic respiratory disease and cervical cancer)
• Child and adolescent health
• Neglected tropical diseases
• HIV/AIDS
• Tuberculosis
• Malaria
• Sexually-transmitted infections
• Surgery and blood transfusion
• Public Health Emergency Management (PHEM) Services
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Health facilities
Version
Version Description
vFINAL: Final report (summary)
Version Date
2017-01-02
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.
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
Universe
The survey covered 705 health facilities across the country.
Producers and sponsors
Primary investigators
| Name |
|---|
| Ethiopian Public Health Institute (EPHI) |
| Ministry of Health |
| World Health Organization |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| World Bank | WB | Financial support |
| Global Fund | Financial support |
Other Identifications/Acknowledgments
| Name | Role |
|---|---|
| World Health Organization | Technical direction and support |
| Federal Ministry of Health | Technical direction and support |
| Health Insurance Agency | Technical direction and support |
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 705 health facilities were selected for the sample. Of these, 228 were hospitals, 165 were health centres, 173 were clinics and 139 were health posts.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2016-09-01 | 2016-11-30 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
A survey team of 83 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
A facility inventory questionnaire to obtain information on how the facilities are prepared to provide each of the priority services was used. The facility inventory questionnaire collects information on the availability of specific items (including their location and functional status), components of support systems (e.g., logistics, maintenance, and management), and facility infrastructure, including the service delivery environment.
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 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
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.
Metadata production
DDI Document ID
DDI-ET-SARA-2016-vFINAL
Producers
| Name | Abbreviation | Role |
|---|---|---|
| World Health Organization | WHO | Documentation of assessment |
Date of Metadata Production
2021-11-10
DDI Document version
DDI-ET-SARA-2016-v06