Scholz Stefan, Ngoli Baltazar, Flessa Steffen
University of Greifswald, Department of Health Care Management, Greifswald, Germany.
GIZ Office Tanzania, Tanzanian German Programme to Support Health, Dar es Salaam, Tanzania.
BMC Health Serv Res. 2015 May 1;15:183. doi: 10.1186/s12913-015-0838-8.
Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure.
A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania).
The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff.
The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.
医疗保健基础设施是卫生系统结构质量的主要组成部分。文献和研究中报道了卫生服务的基础设施缺陷。有多种评估基础设施的工具。然而，在发展中国家，尚无易于使用的评估卫生设施基础设施的工具。现有工具不适用于卫生设施工作人员进行快速评估。因此，卫生信息系统缺乏有关设施基础设施的数据。
作者开发了一种用于初级卫生保健设施基础设施的快速评估工具，并在坦桑尼亚进行了试点测试。该工具全面且高度标准化地衡量所有基础设施组件的质量。评级采用2 - 1 - 0方案，这在坦桑尼亚医疗服务中经常使用。从评估中获得基础设施指标和指数，用于报告和追踪干预措施。该工具在坦噶地区（坦桑尼亚）进行了试点测试。
试点测试涵盖了从诊疗所到地区医院范围内的七家初级保健设施。评估涵盖了这些设施整体以及42座设施建筑和80件医疗技术设备。由医疗保健专业人员对设施基础设施进行全面评估，而由设施工作人员进行快速评估。发现了严重的基础设施缺陷。快速评估工具被证明是卫生设施工作人员进行常规数据收集的可靠工具。
作者建议将快速评估工具纳入发展中国家的卫生信息系统。这样，分权卫生系统中的卫生当局就能发现基础设施缺陷并追踪干预措施的效果。该工具可为地区设施基础设施管理奠定数据基础。
