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DHS-7 MID-TERM EVALUATION: SERVICE PROVISION ASSESSMENT IMPLEMENTATION, UTILIZATION, AND PROMOTION

The Global Health Program Cycle Improvement Project (GH Pro) conducted the mid-term
evaluation of the seventh generation of the Demographic and Health Surveys (DHS) Program,
implemented by ICF International and partners. The Service Provision Assessment (SPA) is a
health facility assessment that describes a country’s health service delivery system. Twenty-four
SPAs have been conducted in 15 countries since the SPA was added to the DHS Program in
1997. The evaluation’s purpose was to assess how well the SPA is positioned “to improve the
collection, analysis, and presentation of population, health, and nutrition data and to facilitate use
of these data for planning, policy-making, and program management.”
The evaluation was guided by three questions: (1) What is the perceived value of SPA at global
and country levels? (2) How are SPA data being used at global and country levels? and (3) What
are USAID’s and ICF’s perceptions about opportunities and challenges facilitating SPA
implementation?
The evaluation design was largely qualitative. The evaluation team conducted 77 interviews with
104 respondents, reviewed documents, and made country visits to Bangladesh and Kenya.
The evaluation found that the SPA has a strong global reputation for producing comprehensive,
high-quality information. However, few SPAs have been conducted and their number is not
increasing, unlike the Service Availability and Readiness Assessment (SARA) and Service Delivery
Indicator (SDI) surveys. The level of investment in the SPA is inadequate in some areas, including
the number of surveys conducted and the dissemination and use of results. The evaluation team
recommends concerted action to strengthen the SPA initiative.

Resource type: 
Evaluation
Operating Unit: 
GH/PRH
Author(s): 
Rachel Jean-Baptiste
Robert McPherson
Publication date: 
September, 2017
Technical Area: 
Contract mechanism: 
GH Pro