IHFAN Partnership Improves Availability of Health Facility Assessment Data

Health facility assessment (HFA) is a methodology designed to provide information for evidence-based decisions at all levels of country health systems. Because of the newness of this data source compared to population based surveys and censuses, HFA data is often overlooked resulting in the underutilization of these data. Limited sharing of information by implementing agencies, exacerbated by weak coordination of organizations participating in HFAs, is another challenge. Poor coordination among partners has created redundancies in data collection, with multiple collections of similar data that are not always compatible across different surveys.  Although the reasons for the incompatibility of data are multiple, the incompatibility of the methodologies that were used to develop these datasets is the heart of the problem.

To meet these challenges, MEASURE Evaluation created a multi-partnership organization, the International Health Facility Assessment Network (IHFAN), to strengthen health facility-based data collection and use, reduce duplication, and promote strategic liaisons around these activities.  The specific objectives of IHFAN are to:

• Improve communication, coordination, and collaboration of health facility assessment (HFA) tools, indicators, data availability and quality at the global level;
• Improve the knowledge of types of HFA, approaches to data collection and their application for management decisions at the global and national levels;
• Establish and promote best practices in the design, implementation, and dissemination of HFA, including tools, methodologies, and guidance in developing HFAs at the global and national levels; and
• Expand the use of HFA data for program management and health policies at the national level.

Earlier this year, IHFAN launched www.ihfan.org which features a metadata repository to improve the availability, quality and use of health facility targeted data in developing countries. Collaborating in this effort were the World Bank, International Household Survey Network (IHSN), Partnership in Statistics for Development in the 21^st Century (PARIS21), managed by the Organization for Economic Co-operation and Development, and Accelerated Data Program, funded by the World Bank. 

The metadata repository pools various survey tools that have achieved best practice status (proven in at least two countries) and supporting documents. Still being developed, it is home to six major HFA instruments:

1. Service Provision Assessment developed by Macro International Inc.
2. Service Availability Mapping developed by WHO
3. Rapid Health Facility Assessment developed by MEASURE Evaluation
4. Health Facility Census developed by the Japan International Cooperation Agency
5. Logistics Indicators Assessment Tools (LIAT) developed by John Snow, Inc.
6. Health Facility based Survey of Human Resource for Health Services developed by Abt Associates

Also featured on www.ihfan.org are metadata sets written into the database using the Microdata Toolkit developed by the World Bank for the IHSN. The toolkit generates metadata compliant with international metadata standards. The metadata is stored in XML format, allowing the generation of all kinds of outputs, including a PDF for ease of reference. The XML metadata is transferred into the site’s searchable databases and catalogues which allow data to be accessed from anywhere. The metadata report is a detailed description of specific questions, variables, and data. The toolkit also permits associated documents to be uploaded so that all data attributes and resources are available in one place.

M&E and health professionals are encouraged to make use of these resources and to join the IHFAN community by subscribing to the listserv to ask questions and learn from other users’ experiences. Subscribe emailing ihfan@who.int. To learn more, Bolaji Fapohunda, Coordinator, at bfapohunda@jsi.com.