Service availability and readiness assessment (SARA)
Reference manual and implementation guide
The Service Availability and Readiness Assessment (SARA) is a health facility assessment tool designed to assess and monitor the service availability and readiness of the health sector and to generate evidence to support the planning and managing of a health system. SARA is designed as a systematic survey to generate a set of tracer indicators of service availability and readiness. The survey objective is to generate reliable and regular information on service delivery (such as the availability of key human and infrastructure resources), on the availability of basic equipment, basic amenities, essential medicines, and diagnostic capacities, and on the readiness of health facilities to provide basic health-care interventions relating to family planning, child health services, basic and comprehensive emergency obstetric care, HIV, TB, malaria, and non-communicable diseases.
Sound information on the supply and quality of health services is necessary for health systems management, monitoring, and evaluation. The efforts to scale up interventions for HIV/AIDS, malaria, safe motherhood, child health, and to achieve the Millennium Development Goals (MDGs) through global health partnerships have drawn attention to the need for strong country monitoring of health services, covering the public, private-for profit, and the private not-for-profit sectors, and their readiness to deliver key interventions. With the increased demand for accountability and the need to demonstrate results at country and global levels, information is needed to track how health systems respond to increased inputs and improved processes over time and the impact such inputs and processes have on improved health outcomes and better health status.
The service availability and readiness assessment (SARA) methodology was developed through a joint World Health Organization (WHO) – United States Agency for International Development (USAID) collaboration to fill critical gaps is measuring and tracking progress in health systems strengthening. The SARA methodology builds upon previous and current approaches designed to assess service delivery including the service availability mapping (SAM) tool developed by WHO, and the service provision assessment (SPA) tool developed by ICF International under the USAID-funded MEASURE DHS project (monitoring and evaluation to assess and use results, demographic and health surveys) project, among others. It draws on best practices and lessons learned from the many countries that have implemented health facility assessments as well as guidelines and standards developed by WHO technical programmes and the work of the International Health Facility Assessment Network (IHFAN).