SPA surveys utilize four main questionnaire types that have been recently revised to meet the needs of national and international public health specialists. The core questionnaire reflects generally accepted standards for health care services, WHO and USAID’s service readiness indicators, UNICEF immunization guidelines, and standards set by the Safe Motherhood Initiative. Before being used in a country, the core questionnaires are adapted to the information and health needs of each country by local technical experts in each service area.
The SPA questionnaires are:
The inventory questionnaire includes 3 modules designed to measure service readiness indicators and several other key maternal and child health indicators. Service readiness indicators are a set of tracer indicators identified through a joint USAID – WHO collaboration to fill gaps in measuring and tracking progress in health system strengthening. The first module collects information on overall availability of different services in health facilities; module 2 collects information on general service readiness-staff coverage, infrastructure, communication, sources of water, electricity, facility infrastructure, health care waste management, processing of equipment for reuse, pharmaceuticals, and laboratory diagnostic capacity; module 3 collects information on service-specific readiness. The inventory questionnaire includes all questions in WHO’s SARA tool which was developed in collaboration with USAID, the International Health Facility Assessment Network (IHFAN), and DHS. The orange color coded questions in the SPA inventory questionnaire are the core SARA questions.
SPA Observation Protocols and Exit Interview Questionnaires
With these protocols, interviewers observe sick child, antenatal care, and family planning consultations to assess how often consultations follow generally accepted standards of care, including integrated management of child illnesses (IMCI). Exit Interview Questionnaires are administered to clients after the observed consultations and before they leave the facility, to assess client’s understanding and recall of provider instructions and other information, and the client’s perception of the service delivery environment.
SPA Health Worker/Provider Interview
The Health Worker/Provider Interview collects information from providers about their professional qualifications, the services they provide and recent in-service training, and their attitudes about the work environment.