2024-02-21-世界卫生组织-HHFA_Indicator_reference_questionnaire_October_2023_163页_2mb

Harmonized Health Facility Assessment (HHFA) Summary

Core Content

The Harmonized Health Facility Assessment (HHFA) is a standardized and comprehensive survey tool designed to collect reliable, objective data on the availability and quality of health services in facilities. It is developed through multistakeholder collaboration, building on existing global tools such as WHO SARA, USAID SPA, and World Bank SDI. The HHFA aims to support health sector reviews and evidence-based decision-making to strengthen country health services and achieve universal health coverage (UHC) and health-related Sustainable Development Goals (SDGs).

Structure and Modules

HHFA is organized into four main modules:

1. Service Availability – Focuses on the presence of key services.
2. Service Readiness – Assesses preparedness and capacity to deliver services.
3. Quality of Care – Evaluates adherence to care standards and quality assurance systems.
4. Management and Finance – Reviews governance, financial systems, and health information systems.

Each module contains stand-alone questionnaires categorized as:

• Core: Essential questions for all assessments.
• Core+Additional: Core questions with added details.
• Supplementary: Additional, context-specific questions.

A Combined questionnaire integrates questions from multiple modules, facilitating efficient data collection.

Questionnaire Format

The HHFA questionnaire is structured into sections and subsections, each containing questions related to specific service aspects. The paper version is typically organized into five columns:

1. Mod: Indicates the module (A = Availability, R = Readiness, M = Management, Q = Quality).
2. No: Question number, which may include sub-questions.
3. Question: The actual question asked to the respondent.
4. Response: Options or fields for responses.
5. Skip: Instructions for skipping to specific questions or sections.

Indicator Reference Questionnaire

An additional column, Indicator ID, is included in the indicator reference questionnaire. It provides a unique three-letter code for each indicator, which can be searched in the HHFA online indicator inventory for detailed metadata.

Resource Package

The HHFA resource package includes the following tools and guidance:

• HHFA Indicator Inventory Platform
• Questionnaires (Core, Core+Additional, Supplementary)
• CSPro Tool: An electronic data collection system.
• Data Analysis Platform
• Comprehensive Guide
• Quick Guide
• Data Manager Guide
• Training Resources
• Global Archive

The resource package is available at: https://www.who.int/data/data-collection-tools/harmonized-health-facility-assessment/introduction

COUNTRY ADAPT Notes

• Some questions require country-specific adaptation to align with local systems, policies, and practices.
• The term "COUNTRY ADAPT" appears in the questionnaire to highlight areas needing customization.
• The questionnaire includes instructions for data collectors and may include GPS data collection procedures to record facility locations.

Sample Consent Form

The consent form is used to inform facility staff about the survey’s purpose and to obtain their agreement. It outlines the survey’s goals, the use of data, and the right of respondents to withdraw at any time. It also includes contact details for survey managers and implementers.

Data Collection Process

• The HHFA data is collected using CSPro, an electronic data collection tool.
• The paper questionnaire is used for planning and adapting the survey to local contexts.
• GPS coordinates are recorded using specific procedures to ensure accuracy and consistency in location data.

Detailed Contents

The HHFA covers a wide range of topics, including:

• Facility identifiers
• Client services
• Health workforce
• Facility beds and isolation units
• Governance and management
• Staff support systems
• Service quality monitoring
• Infrastructure and equipment maintenance
• Health financing and accounting
• Data sources and systems
• Facility data reporting systems
• Basic infrastructure and systems
• Outpatient service conditions
• Communicable diseases services
• Noncommunicable diseases services
• Mental health and neurological services
• Special needs services
• Maternal and newborn services
• Abortion care services
• Services for children under 5 and adolescents
• Immunization services
• Delivery, postnatal, and newborn services
• HIV services
• TB services
• Surgical services
• Emergency services
• Imaging and specialty services
• Blood transfusion services
• Laboratory services
• Consumable commodities
• Pharmaceutical commodities

Key Features

• Standardized indicators and questionnaires ensure consistency across countries.
• Adaptability allows for customization to local needs and systems.
• Comprehensive coverage of health facility aspects.
• Support for quality services is a recurring theme across modules.
• Electronic data collection via CSPro enhances efficiency and data accuracy.

Acknowledgements

The HHFA modules and resource package were developed with support from various international organizations and funding bodies, including:

• Bloomberg Philanthropies Data for Health Initiative
• Gavi, the Vaccine Alliance
• The Global Fund to Fight AIDS, Tuberculosis and Malaria
• The Susan T. Buffett Foundation
• The Kingdom of Saudi Arabia
• The Norwegian Agency for Development Cooperation (Norad)
• The Canada Department of Foreign Affairs, Trade and Development (DFTAD)

The ministries of health in Burkina Faso, Kenya, Liberia, Malawi, and Zambia provided support for testing the HHFA modules and resource package.

Feedback and Updates

The HHFA questionnaire is updated based on implementation experience and user feedback. Users can submit comments through the HHFA feedback form at: https://feedback.hhfa.onlin