Rwanda - Rwanda Service Provision Assessment Survey 2001

A representative sample of facilities, a sample of health service providers at each facility, and a sample of ANC and child health clients were selected.

The sample was selected to provide national- and provincial-level representation of health facilities offering maternal, child, and reproductive health services. These included hospitals, health centers, and dispensaries managed by the government (public) or by NGOs operating under agreement with the government (GAHFs). Private pharmacies, doctor’s offices, and private clinics were not included in the sample.

The sample of health service providers was selected from providers who were present in the facility on the day of the survey and who provided services that were assessed by the RSPA. In facilities with fewer than 10 health providers, all of the providers present on the day of the visit to the unit were interviewed. In facilities where there were more than 10 providers, all providers whose work was observed were interviewed, and a random selection of the providers not selected for observation was interviewed to
compile a minimum of 10 provider interviews. The selection was carried out to ensure that, if available, at least one provider from each service was interviewed even if no observations were conducted for that service.

Outpatient consultation services for sick children under age 59 months and ANC client consultations were observed. The sample of observations was opportunistic, meaning that clients were selected for observation as they arrived because there was no way to know how many eligible clients would attend the facility the day of the survey. When there were several eligible clients waiting for service, an effort was made to ensure that children with sickness (rather than injury or skin or eye infections) were selected for observation and that there was a mixture of new and follow-up ANC clients observed. The ratio observers aimed for was "2 new for every 1 follow-up case" for ANC. Cases were not always available to allow this objective to be met.


To ensure the sample included an appropriate number of facilities to permit analysis according to the type of facility and province, the facilities in some provinces were over-sampled. Because the sample distribution for the selected health facilities was not directly proportional to the distribution of the facilities in the universe, there was a potential for the findings to be biased. Therefore, data were weighted during analysis to account for the differentials caused by over-sampling.
Provider data were weighted for analysis to ensure that analysis provided data representative of the eligible providers. There were no refusals for the interviews.