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Malawi - Harmonized Health Facility Assessment : 2018-2019 Report : Main Report (Английский)

The 2018-2019 Malawi Harmonized Health Facility Assessment was conducted to ascertain the availability , readiness, and quality of health service delivery at the facility to better understand existing gaps and identify potential approaches for improving health care services and ultimately health outcomes in Malawi. The survey focused on better understanding supply, and demand, side constraints on the provision and utilization of reproductive, maternal, newborn, and child health, nutrition services, infectious disease services, and noncommunicable disease services given that despite steady programmatic gains, health outcomes remain relatively poor. The HHFA provides critical information on multiple dimensions of service delivery which are all required to be present in the facility at the same time to promote care-seeking behaviors and ensure that individuals receive high quality health services. These key dimensions include service availability, service readiness, providers’ presence and clinical knowledge, and client responsiveness. The Malawi HHFA was conducted between November 2018 and March 2019 in a census of health facilities and included 1106 health facilities. Of the surveyed facilities, there were 101 hospitals, 492 health centers, and 513 dispensaries, clinics, and health posts. A total of 12, 773 health care workers were observed for absenteeism, 1433 health workers were assessed with clinical vignettes, and 4118 clients were interviewed (2333 mothers regarding their children under the age of 5 and 1785 pregnant women receiving ANC). The Malawi HHFA approach of harmonizing the SARA and SDI tools is one of the first approaches to assess both supply and demand dimensions of health care quality and responsiveness. In addition, the HHFA approach has proven to be programmatically powerful and useful for identifying health systems strengthening needs. The information provided through this assessment provides health sector stakeholders with an evidence-base on which to guide, inform, and plan for health service interventions and can be used as a tool for advocacy and policy dialogue at global, national, regional, and district levels in Malawi.

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