DDI-UGA-SARA-2012-vFINAL World Health Organization 2022-04-06 NADA Final version (2013) Uganda Service Availability and Readiness Assessment (SARA) 2012 UGA-MOH-SARA-2012-vFINAL Ministry of Health World Health Organization NADA Service Availability and Readiness Assessment [hfa/sara] vFINAL: Summary report The Uganda Ministry of Health in collaboration with World Health Organization (WHO) implemented a Service Availability and Readiness Assessment (SARA) in 2012. The SARA 2012 was conducted to assist the health sector in assessing and monitoring service readiness and capacity at district and health facility levels; assessing the equitable and appropriate distribution of services and resources as well as providing the health sector with skills and tools for monitoring service and resource availability on a more regular basis with limited external support. The SARA 2012 covered 102 health facilities in five districts across five geographical zones in the country. 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 infection prevention • Diagnostic capacity • Essential medicines 3. Service specific availability and readiness • Family planning • Antenatal care • Basic obstetric care • Comprehensive obstetric care • Child immunization • Preventive and curative services for children under five years of age • Adolescent health • Malaria • Tuberculosis • HIV counselling and testing • HIV care and support • Antiretroviral therapy • Prevention of mother-to-child transmission of HIV (PMTCT) • Sexually-transmitted infections • Non-communicable diseases • Surgical services • Blood transfusion • Advanced diagnostic • High level diagnostic equipment Uganda Nationally representative as well as at regional (geographical zones) and district levels Health facilities The survey covered 102 health facilities in five districts across five geographical zones in the country Sample survey data [ssd] 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 sample of 102 health facilities in five districts across five geographical zones in the country (based on UDHS regions: central 1 and 2, eastern and eastern central, west and south west, north and west Nile, and Kampala), plus 3 regional referral hospitals were selected for inclusion in the survey. One district was sampled randomly from each of the five zones, and 20 to 25 health facilities were selected from each district. Face-to-face [f2f] 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 questionnaires were adapted to country specific requirements and national treatment guidelines. Twenty data collectors (nurses, clinical officers, students, interns) and five field supervisors were trained in early August 2012 on data collection methodology, questionnaire content, and electronic data collection tools. Data collection took place over a period of three weeks and was completed by the end of August. Ministry of Health