SPA Overview

The Service Provision Assessment (SPA) is a health facility survey that collects information on service availability and Quality of Care (QoC) measures within a country’s health system. SPAs fill an urgent need for actionable monitoring data in participating countries. The SPA assesses availability and QoC for a wide variety of services with a focus on antenatal care (ANC), family planning (FP), maternity care, and sick child services. Quality of Care measures include indicators in two dimensions: structural quality (physical and human resources) and process quality (provision of care and experience of care).

SPA_QoC_Framework_FinalSummary

The SPA was redesigned in 2022 in collaboration with technical experts, representatives from WHO, UNICEF, Ministries of Health, and others, to make the SPA indicator-driven and refocused on QoC.  

Key services and topics assessed in the SPA include:

  • Child Health: Availability of childhood vaccines, medicines, and nutritional supplements; equipment and supplies for outpatient care, growth monitoring and nutrition assessment; adherence to guidelines for care of sick children; assessment and treatment of acute malnutrition; client experience of care.
  • Antenatal Care: Availability of equipment, medicines, and supplies; appropriate assessment of clients for antenatal care; client experience of care.
  • Delivery and Newborn Care: Availability of equipment, medicines and supplies, delivery services; newborn care including assessment of resuscitation skills through simulation; early postpartum counseling for mother and newborn; client experience of care.
  • Family Planning: Availability of contraceptives and supplies; counseling and client assessment; provision of STI treatment for family planning clients; client experience of care.
  • Malaria: Availability of malaria diagnosis and treatment equipment, medicines, and supplies; laboratory diagnostic capacity; rapid diagnostic testing; adherence to guidelines for sick children diagnosed with fever or malaria; caretaker experience of care.
  • Nutrition: Availability of growth monitoring and nutritional screening for children; availability of nutrition-related equipment, medicines, nutritional supplements, and supplies; appropriate nutritional messages; counseling during pregnancy; prevention of mother to child transmission (PMTCT); newborn services; sick child services.
  • Health System Strengthening:  HMIS, management meetings, client opinion and feedback, quality management activities like audit or mortality review, external supervision, professional development, quality improvement.
  • Water, Sanitation, and Hygiene (WASH): Availability of improved water source; infection prevention and control (IPC); waste management; basic sanitation services including specific types of toilets.
  • Emergency Preparedness*: Availability of emergency services 24 hours a day; emergency plans; stockpile of essential medicines set aside for any emergency observed.
  • Gender-Based Violence*: Availability of gender-based violence care services.
  • HIV/AIDS: Availability of HIV counseling and testing services; HIV/AIDS care and treatment services; antiretroviral treatment; PMTCT; post-exposure prophylaxis; voluntary medical male circumcision; nutrition assessment, counseling, and support (NACS) services.
  • Non-Communicable Diseases: Availability of diagnosis and treatment services for diabetes, cardiovascular, and chronic respiratory diseases; availability of medicines, guidelines, basic supplies, and equipment.
  • Post-Abortion Care*: Availability of post-abortion care services.
  • Primary Health Care: Availability of basic services, basic equipment, essential drugs, and supplies.
  • Reproductive Cancers*: Availability of breast cancer and cervical cancer screening services.
  • Sexually Transmitted Infections (STIs): Diagnosis and treatment of STIs other than HIV; referrals for HIV counseling and testing; availability of STI guidelines.
  • Tuberculosis: Availability of TB diagnostic and treatment services.

*New in revised SPA

 

SPA Resources