HIVService Provision Assessment HSPA Survey

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HIV-Service Provision Assessment (HSPA) Survey

• Nancy Fronczak
• ORC Macro

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Context for HSPA and M E for HIV/AIDSrelated
activities

• Ultimate objectives
• Lower incidence of HIV/AIDS
• Longer/better quality-of-life for people who have
  HIV/AIDS

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How to monitor change?

• Measurable changes in population based indicators
  evident a period of time after interventions
  (years)
• Need proximate indicators for interventions for
  early identification of problems

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Proximate indicators health service
interventions

• Some information already available with well
  functioning HMIS
• Distribution of inputs and service statistics
• Limitation of HMIS information
• Inputs dont automatically translate into
  programs
• Service statistics lack information on quality
• Quality of service statistics variable

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What is the HSPA?

• National level facility/service-site
• HIV/AIDS services
• Information for international indicators for
  quality HIV/AIDS services
• (WHO, UNAIDS, USAID, CDC, NGOs)

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Proximate indicators health service
interventions

• HSPA measures inputs and activities for achieving
  outputs- are the services there and do they meet
  expected standards
• HSPA provides information on continued presence
  of elements over time
• HSPA provides independent validation of HMIS
  information

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HSPA Sample

• Nationally representative information, by
  facility type
• Most often health facilities (all levels)
• Sometimes stand-alone sites (VCT)
• Managing authority Government, private
  not-for-profit (e.g., mission, NGO)
• Limited private for-profit (VCT, ART), limited
  other (e.g., military)
• Sample size usually 250-400 facilities

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HSPA Methodology

• Key informant interviews (most knowledgeable
  about a service)
• Observations of facility resources in service
  area
• Interviews with service providers
• 1 day per facility
• Data collected by teams of 2 health personnel
  (nurses) each
• Data are confidential

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HSPA Content

• Services (components)
• E.g., PMTCT (test, ARV,infant feeding, family
  planning)
• Systems, resources, infrastructure to support
  quality services

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HSPA Content

• Services
• VCT
• PMTCT()
• Basic and advanced level clinical services for
  HIV/AIDS (in/out patient)
• ART
• Post-exposure prophylaxis (PEP)
• TB, STI, Malaria

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HSPA Content

• Systems
• Guidelines
• Referrals
• Service records (source of HMIS)
• Individual client records
• Supervised staff
• Resources
• Laboratory diagnostics
• Equipment
• Pharmaceuticals and supplies
• Trained staff

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Content of the HSPA

• Infrastructure
• Privacy
• Furnishing
• Water
• Electricity
• Toilet/latrine
• Infection control

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Outputs of the HSPA(Uganda 2002)

• 226 facilities (AIM, JSI, Macro, MOH)
• Service availability Percentage
• VCT 11
• PMTCT 6
• Clinical care HIV/AIDS 63

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Outputs of the HSPA(Uganda 2002)

• Among those providing VCT

Percent
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Outputs of the HSPA(Ghana 2002)

• Service availability (n428)

Percent
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Outputs of the HSPA(Ghana 2002)

• Among those providing HIV/AIDS services (n111)
• Component Percentage
• Offer HIV testing 41
• HIV test kits 41
• Infection control elements 78
• (soap, water, latex gloves)

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Outputs of the HSPA (Ghana 2002)

• Items for Quality Counseling