Service Provision Assessment Survey 2002
Ghana, 2002
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Identification
Survey ID Number
GHA_2002_SPA_v01_M
Title
Service Provision Assessment Survey 2002
Country
| Name | Country code |
|---|---|
| Ghana | GHA |
Study type
Demographic and Health Survey [hh/dhs]
Abstract
The 2002 Ghana Service Provision Assessment (GSPA) is a survey designed to obtain information about the general performance of facilities that offer maternal, child, and reproductive health services, as well as services for sexually transmitted infections (STIs) including HIV/AIDS. From a representative sample of public and nongovernment facilities, information was collected to provide a picture of the strengths and weaknesses of the service delivery environment for each assessed service. The information on health services and health service providers from the GSPA survey will enable policymakers and program administrators to develop effective strategies for improving health service utilization and coverage and prioritizing recources in ways that will lead to improved health outcomes.
The GSPA survey provides representative regional and national information on both government and nongovernment facilities. The findings complement the household-based health information from the 1998 Ghana Demographic and Health Survey (Ghana Statistical Service and Macro International, 1999). This survey provided information on the health of the population and the utilization of health services.
The primary objectives of the GSPA survey were the following:
• To describe the preparedness of government and nongovernment health facilities in Ghana to provide quality child and reproductive health services
• To describe the preparedness of government and nongovernment health facilities in Ghana to provide quality services for sexually transmitted infections (STIs) including HIV/AIDS
• To identify gaps in the support services, resources, or the processes used in providing client services that may affect the ability of facilities to provide quality services
• To describe the processes used in providing child, maternal, and reproductive health services and the extent to which accepted standards for quality service provision are followed
• To provide comparisons on findings between regions in Ghana and, at a national level, between different types of facilities as well as those operated by different authorities (i.e., government or nongovernment)
• To describe the extent to which clients understand what they must do to follow up on the service received so that the best health outcome is achieved.
The GSPA survey provides representative regional and national information on both government and nongovernment facilities. The findings complement the household-based health information from the 1998 Ghana Demographic and Health Survey (Ghana Statistical Service and Macro International, 1999). This survey provided information on the health of the population and the utilization of health services.
The primary objectives of the GSPA survey were the following:
• To describe the preparedness of government and nongovernment health facilities in Ghana to provide quality child and reproductive health services
• To describe the preparedness of government and nongovernment health facilities in Ghana to provide quality services for sexually transmitted infections (STIs) including HIV/AIDS
• To identify gaps in the support services, resources, or the processes used in providing client services that may affect the ability of facilities to provide quality services
• To describe the processes used in providing child, maternal, and reproductive health services and the extent to which accepted standards for quality service provision are followed
• To provide comparisons on findings between regions in Ghana and, at a national level, between different types of facilities as well as those operated by different authorities (i.e., government or nongovernment)
• To describe the extent to which clients understand what they must do to follow up on the service received so that the best health outcome is achieved.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Facilities
Scope
Notes
The 2002 Ghana Service Provision Assessment survey covered the following topics:
- Facility Identification
- General Informaiton
- STI and HIV/AIDS Services
- Laboratory Diagnostics
- Contraceptive Supplies
- Essential Medications and Supplies for Providing Services for Sick Children, Maternal Health and Clients with Sexually Transmitted Infections
- Supplies
- Immunization Services
- Child Health Services
- Family Planning Services
- Antenatal Care
- Maternal Health Services
- Delivery Care
- Provider Training and Experience
- Child Health Care
- Family Planning
- New Born Care
- Post Natal Care
- Supervision
- Provider Opinion
- Provider Interaction with Child and Caretaker
- Classification and Treatment
- Caretaker Satisfaction
- Family Planning Client Consultation Observation
- Client Counselling
- Clinical Observation
- Client’s Family Planning Status
- Facility Identification
- General Informaiton
- STI and HIV/AIDS Services
- Laboratory Diagnostics
- Contraceptive Supplies
- Essential Medications and Supplies for Providing Services for Sick Children, Maternal Health and Clients with Sexually Transmitted Infections
- Supplies
- Immunization Services
- Child Health Services
- Family Planning Services
- Antenatal Care
- Maternal Health Services
- Delivery Care
- Provider Training and Experience
- Child Health Care
- Family Planning
- New Born Care
- Post Natal Care
- Supervision
- Provider Opinion
- Provider Interaction with Child and Caretaker
- Classification and Treatment
- Caretaker Satisfaction
- Family Planning Client Consultation Observation
- Client Counselling
- Clinical Observation
- Client’s Family Planning Status
Coverage
Geographic Coverage
National
Producers and sponsors
Primary investigators
| Name |
|---|
| Ghana Statistical Service (GSS) |
Producers
| Name | Role |
|---|---|
| ORC Macro, under the MEASURE DHS+ project | Technical assistance |
| Health Research Unit | Support in both human and material (vehicles) resources |
| Ministry of Health | Support in both human and material (vehicles) resources |
| Ghana Registered Midwives Association | Support in both human and material (vehicles) resources |
| Planned Parenthood Association of Ghana | Support in both human and material (vehicles) resources |
| National Population Council | Support in both human and material (vehicles) resources |
Funding Agency/Sponsor
| Name | Abbreviation | Role |
|---|---|---|
| United States Agency for International Development | USAID | Financial assistance |
Sampling
Sampling Procedure
Sample
A representative sample of facilities; a sample of health service providers at each facility; and a sample of sick child, family planning, antenatal, and STI clients were selected.
Note: See detailed sampling information in the final report which is presented in this documentation.
A representative sample of facilities; a sample of health service providers at each facility; and a sample of sick child, family planning, antenatal, and STI clients were selected.
Note: See detailed sampling information in the final report which is presented in this documentation.
Data Collection
Dates of Data Collection
| Start | End |
|---|---|
| 2002-04 | 2002-09 |
Data Collection Mode
Face-to-face [f2f]
Data Collection Notes
Training and Supervision of Data Collectors
Technical advisors from the MoH and the Health Research Unit (HRU) assisted the GSS to train 54 data collectors, 48 of whom were selected. Twelve data collectors were selected to pretest the survey instruments. Three teams pretested the instruments in Greater Accra and in the eastern and central regions of the country.
All of the data collectors were nurses. Training included practical experience in completing all questionnaires in different types of health facilities, as well as role-play for the observation and exit interviews.
In total, 15 teams of three persons each participated in the data collection. Each team was composed of a team leader and two interviewers/observers. For quality control, data collection teams were supervised throughout the field activities, and for some sections of the questionnaires reinterviews were done.
Methods for Data Collection
Each team received a list of facilities to be visited. Data collection took one day in most facilities, with two days being allotted to hospitals, if required. In addition, if one of the observed services was not being offered on the day of the survey, the team returned on a day when the service was offered. If the service was offered, the clients for that day were observed. If the service was offered but no clients came (as occurred occasionally with consultations for sick children and with STI clients), the team did not revisit the facility.
The team leader was expected to ensure that the informant for each component of the facility survey was the most knowledgeable person for the particular health service or system component being addressed. Where relevant, the data collector indicated whether a specific item being assessed was observed, reported available but not observed, not available, or whether it was uncertain if the item was available. Equipment, supplies, and resources for specific services were required to be in the relevant service delivery area or in an immediately adjacent room to be accepted as available. Informed consent was taken from the facility director and all respondents for the Facility Resources Questionnaire, from observed and interviewed providers, and from clients for observations and exit interviews.
Technical advisors from the MoH and the Health Research Unit (HRU) assisted the GSS to train 54 data collectors, 48 of whom were selected. Twelve data collectors were selected to pretest the survey instruments. Three teams pretested the instruments in Greater Accra and in the eastern and central regions of the country.
All of the data collectors were nurses. Training included practical experience in completing all questionnaires in different types of health facilities, as well as role-play for the observation and exit interviews.
In total, 15 teams of three persons each participated in the data collection. Each team was composed of a team leader and two interviewers/observers. For quality control, data collection teams were supervised throughout the field activities, and for some sections of the questionnaires reinterviews were done.
Methods for Data Collection
Each team received a list of facilities to be visited. Data collection took one day in most facilities, with two days being allotted to hospitals, if required. In addition, if one of the observed services was not being offered on the day of the survey, the team returned on a day when the service was offered. If the service was offered, the clients for that day were observed. If the service was offered but no clients came (as occurred occasionally with consultations for sick children and with STI clients), the team did not revisit the facility.
The team leader was expected to ensure that the informant for each component of the facility survey was the most knowledgeable person for the particular health service or system component being addressed. Where relevant, the data collector indicated whether a specific item being assessed was observed, reported available but not observed, not available, or whether it was uncertain if the item was available. Equipment, supplies, and resources for specific services were required to be in the relevant service delivery area or in an immediately adjacent room to be accepted as available. Informed consent was taken from the facility director and all respondents for the Facility Resources Questionnaire, from observed and interviewed providers, and from clients for observations and exit interviews.
Data Collectors
| Name | Abbreviation |
|---|---|
| Ghana Statistical Service | GSS |
Questionnaires
Questionnaires
Four types of survey instruments were used for data collection:
• Facility Resources Questionnaire on resources, infrastructure and support services. The Facility Resources Questionnaire was designed to obtain information on the facilities’ preparedness to provide each of the priority services. The questionnaire was used to collect information on the availability of specific items (including their location and functional status), components of support systems (such as logistics, maintenance, and management), and facility infrastructure, including the environment in which the services are delivered. The resources assessed were those necessary to provide a level of service that meets generally accepted standards. The support services are those that are commonly acknowledged as essential management tools for maintaining health services.
• Provider interview. Providers of health services were interviewed for information on their qualifications (training, experience, continued in-service training), the supervision they had received, and their perceptions of the service delivery environment.
• Observation protocols tailored to the service being provided. Observations of consultations for sick children, antenatal care, family planning, and STIs were conducted to assess the extent to which service providers adhered to standards based on generally accepted procedures and examinations and the content of information exchanged between the provider and the client (history, symptoms, and counselling) were components of the observation.
• Exit interview with the client who was observed receiving a service. The exit interview assessed the client’s understanding of the consultation or examination as well as his or her recollection of instructions received on treatment and preventive behaviour. The ability to recall key messages increases the likelihood that a client will be able to successfully follow treatment protocols and implement preventive behaviours that optimize health outcomes. Information was also collected on the client’s perception of the service delivery environment.
These instruments were based on generic questionnaires developed in the MEASURE DHS+ project and were adapted after consulting with technical specialists from the MoH, USAID, and NGOs knowledgeable about the health services and service programme priorities covered by the GSPA survey.
• Facility Resources Questionnaire on resources, infrastructure and support services. The Facility Resources Questionnaire was designed to obtain information on the facilities’ preparedness to provide each of the priority services. The questionnaire was used to collect information on the availability of specific items (including their location and functional status), components of support systems (such as logistics, maintenance, and management), and facility infrastructure, including the environment in which the services are delivered. The resources assessed were those necessary to provide a level of service that meets generally accepted standards. The support services are those that are commonly acknowledged as essential management tools for maintaining health services.
• Provider interview. Providers of health services were interviewed for information on their qualifications (training, experience, continued in-service training), the supervision they had received, and their perceptions of the service delivery environment.
• Observation protocols tailored to the service being provided. Observations of consultations for sick children, antenatal care, family planning, and STIs were conducted to assess the extent to which service providers adhered to standards based on generally accepted procedures and examinations and the content of information exchanged between the provider and the client (history, symptoms, and counselling) were components of the observation.
• Exit interview with the client who was observed receiving a service. The exit interview assessed the client’s understanding of the consultation or examination as well as his or her recollection of instructions received on treatment and preventive behaviour. The ability to recall key messages increases the likelihood that a client will be able to successfully follow treatment protocols and implement preventive behaviours that optimize health outcomes. Information was also collected on the client’s perception of the service delivery environment.
These instruments were based on generic questionnaires developed in the MEASURE DHS+ project and were adapted after consulting with technical specialists from the MoH, USAID, and NGOs knowledgeable about the health services and service programme priorities covered by the GSPA survey.
Data Processing
Other Processing
Data Entry
Data entry was conducted by the GSS staff. CSPro software developed by ORC Macro and the U.S. Census Bureau was used for data entry. Double entry of all questionnaires was carried out to identify possible entry errors. This operation took place from June through September 2002.
Data Analysis
The design of the tabulation plan and the preparation of the programmes for the production of statistical tables were carried out from October through December 2002. Data analysis and clarification of questionable results were carried out from January through March 2003. During the process of data analysis, revisions were made to the analysis plan, based on feedback from MoH and the GSPA survey technical advisors, to ensure that the analysis was appropriate for the Ghanaian health system.
Data entry was conducted by the GSS staff. CSPro software developed by ORC Macro and the U.S. Census Bureau was used for data entry. Double entry of all questionnaires was carried out to identify possible entry errors. This operation took place from June through September 2002.
Data Analysis
The design of the tabulation plan and the preparation of the programmes for the production of statistical tables were carried out from October through December 2002. Data analysis and clarification of questionable results were carried out from January through March 2003. During the process of data analysis, revisions were made to the analysis plan, based on feedback from MoH and the GSPA survey technical advisors, to ensure that the analysis was appropriate for the Ghanaian health system.
Access policy
Contacts
| Name | URL | |
|---|---|---|
| General Inquiries | info@measuredhs.com | www.measuredhs.com |
| Data and Data Related Resources | archive@measuredhs.com | www.measuredhs.com |
Access conditions
DISSEMINATION POLICY
MEASURE DHS believes that widespread access to survey data by responsible researchers has enormous advantages for the countries concerned and the international community in general. Therefore, MEASURE DHS policy is to release survey data to researchers after the main survey report is published, generally within 12 months after the end of fieldwork. with few limitations these data have been made available for wide use.
DISTRIBUTION OF DATASETS
MEASURE DHS is authorized to distribute, at no cost, unrestricted survey data files for legitimate academic research, with the condition that we receive a description of any research project that will be using the data.
Registration is required for access to data.
Datasets are available for download to all registered users, free of charge. To download datasets, you must first register online and request the country(ies) and datasets that you are interested in. When submitting a dataset request, users must include a brief description of how the data will be used.
DATASETS TERMS OF USE
Datasets are made available with the following conditions:
- Survey data files are distributed by MEASURE DHS for academic research/statistical analysis. Researchers need to provide a description of any research/analysis that will be using the data, before access is granted to the datasets.
- Once downloaded, the datasets must not be passed on to other researchers without the written consent of MEASURE DHS.
- All reports and publications based on the requested data must be sent to the MEASURE DHS Data Archive as a Portable Format Document (pdf) or a hard copy, for us to forward to the country(ies) whose data have been used.
More information on the access policy and terms of use is available at http://www.measuredhs.com
MEASURE DHS believes that widespread access to survey data by responsible researchers has enormous advantages for the countries concerned and the international community in general. Therefore, MEASURE DHS policy is to release survey data to researchers after the main survey report is published, generally within 12 months after the end of fieldwork. with few limitations these data have been made available for wide use.
DISTRIBUTION OF DATASETS
MEASURE DHS is authorized to distribute, at no cost, unrestricted survey data files for legitimate academic research, with the condition that we receive a description of any research project that will be using the data.
Registration is required for access to data.
Datasets are available for download to all registered users, free of charge. To download datasets, you must first register online and request the country(ies) and datasets that you are interested in. When submitting a dataset request, users must include a brief description of how the data will be used.
DATASETS TERMS OF USE
Datasets are made available with the following conditions:
- Survey data files are distributed by MEASURE DHS for academic research/statistical analysis. Researchers need to provide a description of any research/analysis that will be using the data, before access is granted to the datasets.
- Once downloaded, the datasets must not be passed on to other researchers without the written consent of MEASURE DHS.
- All reports and publications based on the requested data must be sent to the MEASURE DHS Data Archive as a Portable Format Document (pdf) or a hard copy, for us to forward to the country(ies) whose data have been used.
More information on the access policy and terms of use is available at http://www.measuredhs.com
Citation requirements
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download of the data files (for datasets obtained on-line)
- the Identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download of the data files (for datasets obtained on-line)
Access authority
| Name | URL | |
|---|---|---|
| MEASURE DHS | archive@measuredhs.com | www.measuredhs.com |
Disclaimer and copyrights
Disclaimer
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.
Metadata production
DDI Document ID
DDI_GHA_2002_SPA_v01_M
Producers
| Name | Abbreviation | Affiliation | Role |
|---|---|---|---|
| Development Economics Data Group | DECDG | World Bank | Generation of the DDI |
Date of Metadata Production
2011-06-30
DDI Document version
Version 01 (August 2011)