WHO has developed a health facility survey tool and an approach to follow-up after training in IMCI (Integrated management of child health), which the Regional office has adapted and used in the Region.
IMCI health facility surveys in the Region
Health facility survey manual
WHO has developed a health facility survey manual to assist country programme managers in evaluating the quality of care delivered to sick children attending outpatient facilities (using the IMCI clinical guidelines as best practices).
The Regional Office for the Eastern Mediterranean (EMRO) has revised the methodology for use in the Region, taking into consideration: a) previous, extensive experience in the conduct of similar health facility surveys on diarrhoeal diseases and acute respiratory infections; and b) needs for adaptation to the situation in countries in the Region.
Major changes in the regional adaptation concern the collection of:
- Information on not only whether key clinical management tasks are performed but also whether they are performed correctly;
- Additional information on items of particular relevance to a particular country setting (e.g., out-of-pocket health expenditure, relationship of caretakers’ report of breathing signs with pneumonia and care-seeking, etc.);
- Qualitative information, as an additional resource for data analysis to assist in the interpretation of the quantitative data. This information, collected using a semi-structured form, includes observations of the survey team on issues mostly related to health systems support, such as organization of work at the facility, medicines (procurement, uninterrupted supply, etc.), referral, utilization of services, routine reporting and constraints to the implementation of the IMCI strategy.
The adapted survey forms are available from the reports on the IMCI health facility surveys conducted in the Region.
The Regional office has developed additional tools to assist in preparing for the survey, collecting the required data and information for planning. The guidelines “Survey procedures and question-by-question explanations” have been thoroughly revised to include more examples and details to meet the needs in the field.
The survey instruments enable the collection of health facility data on child health service indicators and, together with data on outcome indicators from other sources, are useful to monitor progress towards the achievement of the child health-related Millennium Development Goals.
Follow-up visits
WHO has developed a standard methodology to conduct follow-up visits after IMCI (Integrated management of child health) training.
These in-depth visits have the objective to reinforce the skills of health providers trained in IMCI, review those health system elements required to support them in the delivery of quality outpatient child health services according to the IMCI strategy, assess caretaker satisfaction with the care received and identify and help solve problems faced by the trained providers.
Staff who conduct follow-up visits receive a standard training on the follow-up methodology and gather information using standard forms.
As such, the follow-up visits are at the same time an integral part of training, a strong supervisory tool and a means of collecting information on health provider performance after training. This last aspect has been used in the Region to assist in monitoring progress in provider performance, as an intermediate step towards measuring final outcome indicators.
Follow-up visits do not replace surveys but may be conducted more frequently to help guide planning and managers’ decisions.
Guidelines for follow-up after training
IMCI health facility surveys in the Region
The Regional Office has directly collaborated and been involved in the planning and conduct of health facility surveys on the quality of outpatient child health services in selected countries in the Region.
Morocco
National Health Facility Survey on the Quality of Outpatient Primary Child Health Care Services – IMCI health facility survey, Morocco, October-December 2007
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Report (pdf, 5.83 Mb) |
Sudan
National Health Facility Survey on the Quality of Outpatient Primary Child Health Care Services – IMCI health facility survey, Sudan, March-April 2003
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Report (pdf 4.08 Mb) |
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Booklet with graphics (pdf 668 KB) |
Egypt
Health Facility Survey on Outpatient Child Care (IMCI) Services, Egypt, March 2002
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Report (pdf 325 kb) |
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Booklet with graphics (pdf 660 kb) |
External resources
United Nations Children’s Fund (UNICEF) - Multiple Indicator Cluster Surveys (MICS)
Country reports, MICS tools and other useful information.
“Countdown to 2015” country profiles
Information on key maternal, neonatal and child interventions, with profiles for 75 countries.
Measure DHS – Demographic and health surveys
Information on hundreds of Demographic and Health Surveys (DHS), other quantitative surveys and qualitative surveys (http://www.measuredhs.com/).
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