Service readiness of health facilities in Bangladesh, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Uganda and the United Republic of Tanzania

• Published in: Bulletin of the World Health Organization 2017-11, Vol.95 (11), p.738-748
• Main Authors: Leslie, Hannah H, Spiegelman, Donna, Zhou, Xin, Kruk, Margaret E
• Format: Article
• Language: English
• Subjects: Bangladesh; Capacity Building; Clinics; Diagnostic systems; Disease; Drugs; Equipment and Supplies - supply & distribution; Expenditures; Financing; Global health; Haiti; Health care; Health care facilities; Health care policy; Health Care Surveys; Health facilities; Health Facilities - statistics & numerical data; Health services; Hospital facilities; Hospitals; Investigations; Kenya; Low income groups; Malawi; Namibia; Nepal; Power; Primary care; Public health; Quality; Quality of care; Quality of Health Care; Regression analysis; Rural areas; Rwanda; Senegal; Sustainable development; Tanzania; Uganda; Underserved populations
• ISSN: 0042-9686; 1564-0604
• DOI: 10.2471/BLT.17.191916

To evaluate the service readiness of health facilities in Bangladesh, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Uganda and the United Republic of Tanzania. Using existing data from service provision assessments of the health systems of the 10 study countries, we calculated a service readiness index for each of 8443 health facilities. This index represents the percentage availability of 50 items that the World Health Organization considers essential for providing health care. For our analysis we used 37-49 of the items on the list. We used linear regression to assess the independent explanatory power of four national and four facility-level characteristics on reported service readiness. The mean values for the service readiness index were 77% for the 636 hospitals and 52% for the 7807 health centres/clinics. Deficiencies in medications and diagnostic capacity were particularly common. The readiness index varied more between hospitals and health centres/clinics in the same country than between them. There was weak correlation between national factors related to health financing and the readiness index. Most health facilities in our study countries were insufficiently equipped to provide basic clinical care. If countries are to bolster health-system capacity towards achieving universal coverage, more attention needs to be given to within-country inequities.