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Rapid Health Facility Assessment 2.1 (R-HFA) 
Methodology
Implementation
- Requires 2-3 data collectors per facility, one of whom should be a health service provider
- Requires about ½ day per facility. In urban settings, two facilities per day can be assessed; in rural areas, only one per day is advisable.
Sampling
- Can be census of all district level health facilities, but also can be sampled, stratified by type of HF (e.g. Hospital OPD, basic facility, etc.), using LQAS - described in manual. A list of Primary Health Care Facilities obtained from the MOH and validated with the DHMT and participating MNCH projects, constitutes the sampling frame.
- Sick child cases and linked caretaker exit interviews - six consecutive cases (treated as approximating a simple random sample)
Data collection tools
Four components (and a fifth optional one):
- Facility Checklist: (based on the ITWG core indicators) To assess the presence of a minimal level of infrastructure, supplies, and medications.
- Health Worker Survey: To assess the staffing, MNCH services offered, as well as frequency of training, supervision, and other key processes.
- Observation Checklist for sick child care: observation of six consecutive cases of care of children with fever,
diarrhea, or breathing difficulty. Assess for adherence to national (IMCI) protocol for assessment,
classification, and treatment.
- Client Exit Interview: To assess correct knowledge of how to administer drugs given for diarrhea,
malaria, and/or breathing difficulty (used a proxy for adequate counseling)
- CHW Survey and Checklist (optional): Collects data for CHWs on 6 of the 12 HF core indicators
- inputs, processes, and service delivery (through examination of registers)
Notes on data collection
Data collectors must be trained and familiar with the area in which health facilities are to be assessed.
Good supervision is required during field work and it is preferable that the supervisors have a health
service background or are technically qualified in health service subject area.
Frequency
Surveys can be done at baseline and final of a project (3-5 years).
A subset of indicators is appropriate for use during ongoing routine supervision
Database structure and analysis tools
Excel data entry sheet (with validation) for up to 40 HF, with automatic construction
of disaggregated frequency tables and bar charts for attainment of set of 12 key indicators
(under construction )
Data analysis plans
See Excel sheet with instruments which have the tabulation plan and the separate Excel data entry sheet
which automatically calculates core indicators
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Oct-06-08
