Ayman Abdelmohsen Abt Associates Measuring the readiness of service delivery to respond to healthcare needs Ayman Abdelmohsen Abt Associates

PATHS2 Service Delivery Approach Expand access to quality services through the provision of a Minimum Package of Health Services. Introduce a replicable, sustainable and scalable Service Delivery Model: Improve Physical facility Improve Capacity of Service Providers Drugs and medical supplies Drug Revolving Fund Service Delivery Information Supportive Supervision System Generate demand for Healthcare, including addressing physical and financial barriers to access.

Approach to measuring readiness PATHS2 approach to measuring readiness of health service delivery: Service availability Service utilization Consumer satisfaction

A. Service Availability: Availability of Minimum Health Care Package at the PHC level. OIC about 19 services comprising the minimum package. Any facility reporting that they have 80% of these was classified as offering a minimum package of care.

A. Service Availability: Availability of Basic Emergency Obstetric Care Services at the PHC level: Eight Basic Parameters: At least one staff trained on MLSS Use of Partographs to monitor labor IV anticonvulsants available IV Oxytocin available IV antibiotics available Staff member who can manually remove placenta available Staff member who can remove retained products of conception Staff member trained to assist in deliveris

B. Service utilization Approximately 82% of those who were ill or injured visited a health facility for treatment. Percentage of ill population visited health facility by wealthy status  Wealthy Quintiles Enugu Jigawa Kaduna Kano All States Poorest 74.4% 81.7% 95.7% 70.0% 75.7% Second 84.8% 79.4% 92.6% 72.1% 77.7% Middle 80.4% 92.7% 93.0% 78.1% 84.0% Fourth 79.9% 94.4% 82.6% 87.2% Richest 76.1% 90.2% 90.9% 84.7% 83.3%

B. Service utilization Approximately 61% of women saw a health professional for ANC during their most recent pregnancy.

C. Service satisfaction Five Parameters to assess satisfaction with services: (Respondents were asked about their satisfaction with services) Attention given by health worker(s) Time spent with health worker(s) Length of waiting time to see health provider Satisfaction with treatment Privacy during consultation and examination Those who responded that they were either satisfied or very satisfied with all 5 parameters were classified as being satisfied with services. 29.1% of respondents reported being satisfied with PHC services.

Service Satisfaction: Characteristics Percentage Location: Urban 33.3 Rural 27.7 State Jigawa 30.5 Kano 24.3 Kaduna 33.8 Enugu 32.4 Wealth Quintile Poorest 22.6 Second 24.8 Middle 30.9 Fourth 34.4 Richest 33.2 Total 29.1

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