Service Provision Assessment Survey 2018-2019
Afghanistan, 2018 - 2019
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AFG_2018_SPA_v01_M
Service Provision Assessment Survey 2018-2019
| Name | Country code |
|---|---|
| Afghanistan | AFG |
Service Provision Assessments [hh/spa]
The 2018-2019 Afghanistan Service Provision Assessment was conducted under the leadership of the Ministry of Public Health and its General Directorate of Monitoring & Evaluation and Health Information Systems. This is the first Afghanistan Service Provision Assessment (AfSPA) to be conducted by the Ministry of Public Health team, with technical support from ICF and financial support from USAID.
The 2018-19 AfSPA collected information on the availability, readiness, and quality of health services in national specialty and provincial/regional hospitals, including major private sector hospitals in seven urban areas of Afghanistan. The assessment focused on family planning and maternal and child health (FP & MCH) services, as well as surgery, pediatrics, emergency, intensive care, institutional delivery, and newborn care in hospitals. At the same time, the assessment provided baseline key information for monitoring these services in the future. The assessment also intended to support dissemination and utilization of the results for the planning and management of FP & MCH programs. Similarly, the assessment supports health planners and program managers to address prioritized weaknesses and develop intervention for public and private hospital programs in the surveyed areas. A long-term objective is to institutionalize capacity to carry out national level assessments and use data for further analysis and future assessment planning, with diminishing external support.
The specific objectives of the 2018-19 Afghanistan Service Provision Assessment (2018-19 AfSPA) were to:
- Collect data on services in national specialty, regional, and provincial hospitals
- Collect data on services in private hospitals
- Collect data on specific services related to maternal and child health within the Afghanistan hospital system in order to set a baseline for service availability, readiness, and compliance with quality standards
Sample survey data [ssd]
Health establishments, hospitals, and health centers
Scope
The 2018-19 Afghanistan Service Provision Assessment survey covered the following topics:
General information and service availability
- General service availability and inpatient services
- General filter questions
General service readiness - 24 hours staff coverage
- Staffing, management, client opinion, quality assurance, transport, HMIS and health statistics
- Processing of instruments for reuse
- Health care waste management and client latrine
- Basic supplies, client examination room client waiting area
- Diagnostics
- Medicines and commodities
Service-specific readiness
Staff listing (health workers available on day of visit)
Health worker interview
Observation of ANC consultation
Observation of family planning consultation
Observation of sick child consultation
Observation of labor and delivery and newborn resuscitation
ANC client exit interview
FP client exit interview
Sick child caretaker exit interview
Emergency inpatient care services
Surgical delivery services
Post abortion care
Coverage
Urban areas
Producers and sponsors
| Name | Affiliation |
|---|---|
| Ministry of Public Health | Government of Islamic Republic of Afghanistan |
| Name | Affiliation | Role |
|---|---|---|
| ICF | The DHS Program | Provided technical assistance through the worldwide DHS Program |
| Name |
|---|
| Government of Islamic Republic of Afghanistan |
| United States Agency for International Development |
Sampling
The study targeted urban areas of seven major provinces (Kabul, Nangarhar, Paktya, Kunduz, Balkh, Kandahar, and Herat) that together contained all major public and private hospitals in Afghanistan. In six provinces, with the exception for Kabul, all 12 public hospitals, 37 private hospitals, and 52 private clinics were included in the sample so universal sampling was applied. In Kabul province, all public and private hospitals (26 public and 20 private hospitals) were also included; however, 13 of 84 private clinics were randomly selected. In total, 160 facilities (38 public hospitals, 57 private hospitals, and 65 private clinics) were included in the study from all seven provinces. The frame was obtained from the Health Management Information Systems (HMIS) department of MoPH and verified with the private health coordination office, but it is possible that private facilities will exceed those listed in the frame.
For further details on sample selection, see Section 2.5 of the final report.
Survey instrument
Afghanistan Service Provision Assessment (AfSPA) used five main types of data collection tools:
- Facility Inventory Questionnaire
- Health Provider Questionnaire
- Observation protocols for antenatal care (ANC), family planning (FP), services for sick children (SC), and institutional delivery
- Exit interview questionnaires for observed consultations during ANC visits and with family planning clients and caretakers of sick children
- Country-specific questionnaires for emergency services and inpatients, surgical and delivery services, and post-abortion care
Data collection
| Start | End |
|---|---|
| 2018-11 | 2019-01 |
| Name | Affiliation |
|---|---|
| Ministry of Public Health | Government of Islamic Republic of Afghanistan |
Data collection was carried out from November 1, 2018, through January 20, 2019, in the seven provinces of Afghanistan, namely Kabul, Nangarhar, Paktya, Kunduz, Balkh, Kandahar, and Herat.
The Facility Inventory, Health Provider, and country-specific questionnaires (emergency services and inpatient care units, surgical and delivery services), and the exit questionnaires, were loaded onto tablet computers, which were used during interviews to ask questions and record responses (via CAPI). The client observation questionnaires (ANC, family planning, sick child, and institutional delivery) were first administered as paper-based questionnaires and later entered in the tablets (via CAFE).
Each AfSPA team was provided four tablet computers. One tablet was dedicated to CAPI for the Facility Inventory Questionnaire, the second tablet was dedicated to Inpatient Hospital Service questionnaires, the third was used to record the responses from CAPI exit interviews and CAFE client observation questionnaires (i.e., for entering and editing data from the paper-based observation protocols), and the fourth one was used for the Health Provider Questionnaire. The fourth tablet was also used for supervisor activities such as receiving completed data from other tablets, reviewing raw data, notes, and other responses, merging data and checking duplicates, checking ID structure, running field editing, and closing the facility and final backup.
Each team was given a list of facilities to visit, names and types of facilities, and the permission letter from the MoPH. At the beginning of fieldwork in a province, the teams were asked to coordinate with the provincial health office and prepare a schedule for visiting the targeted facilities. Data collection required 1 to 4, even 5 days, per facility depending on the type of facility. Interviewers ensured that respondents to the various sections of the Facility Inventory Questionnaire were the most knowledgeable persons with respect to the particular service or system components being assessed.
Every effort was made to ensure that teams visited facilities on days and at the time of the day when ANC, family planning, or sick child services would be offered, since the assessment involved observation of these consultations. Whenever a service of interest was not being offered on the day of the visit, the teams returned on a day when the service was offered to observe consultations and interview clients. If the service was offered on the day of the visit, but no clients came in for the service, the team did not revisit the facility.
One master trainer was assigned for each team to continuously coordinate the team member and supervise the fieldwork. Close contact between the AfSPA central office and the teams was also maintained through master trainers using Internet-based communication group.
Access policy
The DHS Program
http://dhsprogram.com/data/available-datasets.cfm
Cost: None
Data Access
| Name | URL | |
|---|---|---|
| The DHS Program | https://www.dhsprogram.com/ | archive@dhsprogram.com |
Request Dataset Access
The following applies to DHS, MIS, AIS and SPA survey datasets (Surveys, GPS, and HIV).
To request dataset access, you must first be a registered user of the website. You must then create a new research project request. The request must include a project title and a description of the analysis you propose to perform with the data.
The requested data should only be used for the purpose of the research or study. To request the same or different data for another purpose, a new research project request should be submitted. The DHS Program will normally review all data requests within 24 hours (Monday - Friday) and provide notification if access has been granted or additional project information is needed before access can be granted.
DATASET ACCESS APPROVAL PROCESS
Access to DHS, MIS, AIS and SPA survey datasets (Surveys, HIV, and GPS) is requested and granted by country. This means that when approved, full access is granted to all unrestricted survey datasets for that country. Access to HIV and GIS datasets requires an online acknowledgment of the conditions of use.
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Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | |
|---|---|---|
| Information about The DHS Program | The DHS Program | reports@DHSprogram.com |
| General Inquiries | The DHS Program | info@dhsprogram.com |
| Data and Data Related Resources | The DHS Program | archive@dhsprogram.com |
Metadata production
DDI_AFG_2018_SPA_v01_M
| Name | Affiliation | Role |
|---|---|---|
| Development Economics Data Group | World Bank Group | Documentation of the DDI |
2020-03-10
Metadata version
Version 01 (March 2020). Metadata is excerpted from "Afghanistan Service Provision Assessment 2018-19" Report.