DDI-BFA-SARA-2018-vFINAL World Health Organization 2021-12-09 NADA Final version (report) Enquete Nationale sur la Disponibilite, la Capacite Operationnelle et la Qualite des Soins Dans les Services de Sante (SARA+QoC) Burkina Faso 2018 National Survey on Availability, Operational Capacity and Quality of Care in Health Services (SARA+QoC 2018) BFA-MOH-SARA-2018-vFINAL Ministry of Health General Directorate of Health Information and Health Statistics General Secretariat World Health Organization NADA World Health Organization The Global Fund to fight AIDS, Tuberculosis and Malaria Service Availability and Readiness Assessment Survey [HFA/SARA] Final report The Burkina Faso Service Availability and Readiness Assessment (SARA) was implemented by the Ministry of Health in collaboration with World Health Organization (WHO) in 2018. The purpose of the SARA 2018 was to provide evidence for the development of the health sector development policies and strategies to improve access to quality health care services in general and malaria, tuberculosis and HIV/AIDS. The overall objective of the survey was to assess the quality of the health care delivery through the availability of resources, equipment, inputs and diagnostic means in the health facilities in order to have updated data for better planning of interventions in the area of health care services. A census of 803 health facilities and a quality of care assessment were conducted. This report presents findings on: o Availability of services in health facilities nationwide o Availability of basic equipment o Availability of medicines and other health products o Availability of treatment guidelines and diagnostic tools o Operational capacity of health facilities to offer specific health services such as child health, reproductive health, malaria, tuberculosis, HIV/AIDS and rehabilitation o The quality of care for malaria, tuberculosis, and HIV/AIDS. Burkina Faso Representative at national and regional levels Health facilities and patients records The survey covered 803 health facilities across Burkina Faso and 11,000 patients records for the QoC. 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). Health facilities were stratified according to region, level of care with representation at the level of the residence and status of the health facilities. An independent random sample was drawn from each stratum. The sampling frame used to select the health facilities was a list of health facilities extracted from the Health Data Warehouse (Endos-BF) for the year 2017. To estimate the level of quality of patient care,two-stage stratified sampling was used. The first stage sample was health facilities and the second stage of sampling was patients in each health facility (HPF). The sample was stratified with a 95% significance level for the indicators at national and regional levels. Face-to-face [f2f] For this assessment, the WHO SARA Version 2.2 questionnaire of July 2014 was used. It was adapted to the country context in some areas. The questionnaire is structured as follows: Section 1: Cover page (identification) Section 2: Personnel Section 3: Inpatient and observation beds Section 4: Infrastructure Section 5: Available Services Section 6: Diagnostics Section 7: Drugs and Other Products Section 8: Investigator's Comments Another questionnaire, the Facility Reported Data Verification Tool version 2.1. was used to assess data quality. This tool was used to verify the provision of specific services in the health facilities as well as the availability and content of source documents and monthly reports. A module on quality of care assessing Malaria, Tuberculosis and HIV/AIDS services was also used. Training of enumerators and supervisors was conducted before data collection. The survey team comprised of technical statisticians and health epidemiology officers from Center for Health Information and Epidemiological Surveillance (CISSE). A total of 110 enumerators were selected for a 25-day data collection. Each team comprised of two enumerators and a team leader. Data collection for SARA 2018 used paper questionnaires. To ensure the quality of the data collected, a counter-survey was conducted where 10% of the health facilities in the sample were revisited. Upon verification and correction in the field by team leaders and survey controllers, the paper-questionnaires were sent to SSD for coding and additional verification before data entry. Data entry and processing was done using a data entry mask designed by WHO on CSPRO (Census and Survey Processing System). After data entry, a multi-disciplinary team was set up to carry out data cleaning with technical support from WHO.