Rwanda - Rwanda Service Provision Assessment Survey 2001

Start	End	Cycle
2001-09-10	2001-11-17	N/A

Face-to-face [f2f]
Data were collected using structured printed instruments. These instruments were based on generic questionnaires developed in the MEASURE DHS+ project and were adapted after consulting with technical specialists from the MoH, nongovernmental organizations (NGOs), and other organizations knowledgeable about the health services and service program priorities covered by the RSPA.

Operational definitions were developed for the health system components that were measured. These were revised for the RSPA after discussions with MoH officials in Rwanda and after the pretest. A training manual was developed and distributed to all data collectors to support standardized data collection.

Each team received a list of facilities to be visited. Data collection took one day in most facilities, with two days being allotted to hospitals, if required. In addition, if one of the observed services (consultation for sick children or ANC) was not being offered the day of the survey, the teams returned on a day when the service was offered. If the service was offered, the clients for that day were observed. If the service was offered but no clients came (as occurred occasionally for consultations for sick children), teams did not revisit the facility.

The team leader was instructed to ensure that the informant for each component of the facility survey was the most knowledgeable person for the particular health service or system component being addressed. Where relevant, the data collector indicated if a specific item being assessed was observed, reported available but not observed, not available, or it was uncertain if the item was available. Equipment, supplies, and resources for specific services were required to be in the relevant service delivery area or in
an immediately adjacent room to be accepted as available. Informed consent was obtained from observed and interviewed providers and from clients for observations and exit interviews.

The Rwanda Service Provision Assessment Survey 2001 was carried out using the following types of questionnaires:
• Health facility inventory. This form collected information on the type of facility and the operating authority. It also collected information regarding furnishings, equipment, personnel, and other items for each service assessed by the RSPA that was provided by the facility. One questionnaire was completed for each facility.
• Health service provider interview. Providers of relevant services were interviewed regarding their technical qualification, supervision received, continuing education received, and experience providing the services that were assessed.
• Observation checklists. Checklists specific to quality curative child care and ANC were used to collect information on procedures conducted and information shared between the provider and the client.
• Exit interviews. Exit interviews were conducted with clients whose ANC consultation had been observed and with the caretaker of observed sick children. The interview covered their perception of what had occurred during the consultation and their opinion on issues related to client satisfaction.

The inventory questionnaire was administered in French, with terminology that was identified as difficult during training translated into Kinyarwanda so that all data collectors would use similar terms. Observation and exit interviews were in French but were also translated into Kinyarwandan for use when appropriate.

Name	Abbreviation	Affiliation
National Population Ofice	ONAPO	Minisry of Health

Researchers from ONAPO were trained on the RSPA methodology and data collection instruments July 17-27, 2001. Data collectors were primarily recruited from applicants who were trained in nursing sciences. The data collectors were trained over a three-week period, August 6-24, 2001.

Nine teams of three people each collected the data. Each team was made up of a team leader and two investigators. The team leader was responsible for the organizing the work of the team and ensuring quality control of the data collected. The team leader completed the inventory questionnaire and the provider interviews. One investigator conducted the observations and the other conducted the exit interviews.

Each group of three teams was under the direction of a supervisor, who was also a team leader. The Technical Coordinating Team, made up of members from ONAPO and the resident advisor from ORC Macro, made weekly visits to each group to ensure the work was being conducted according to correct survey methodology and to provide quality control of the data collected.