DDI-KEN-SARAM-2013-vFINAL World Health Organization 2021-11-14 NADA Final version: report Service Availability and Readiness Assessment Mapping (SARAM) Kenya 2013 KEN-MOH-SARAM-2013-vFINAL Ministry of Health World Health Organization NADA Department for International Development Service Availability and Readiness Assessment Mapping Survey [HFA/SARAM] vFINAL: Final report 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 Kenya Nationally representative, as well as representative at zonal levels Health facilities and health management units The survey covered 8,401 health facilities in 10 country zones. 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). 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. 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 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. 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. 88% Government of Kenya, 2014: Kenya Service Availability and Readiness Assessment Mapping (SARAM). Ministry of Health, Nairobi Kenya