Harmonized Health Facility Assessment (HHFA)

Introduction

The Harmonized Health Facility Assessment (HHFA) is a comprehensive health facility survey that assesses the availability of health facility services and the capacities of facilities to provide services at required standards of quality.

Availability and quality of health services are integral to strong primary health care and universal health coverage and contribute to achieving the sustainable development goals. HHFA data can support evidence-based decision-making in health sector reviews, planning, management and policy making. Based on global service standards and developed through multi-stakeholder collaboration, the HHFA builds on the WHO Service Availability and Readiness Assessment (SARA) as well as other global health facility survey tools and indicator lists. The HHFA is a key product of the Health Data Collaborative (HDC).

The HHFA includes four modules: 1. Service availability, 2. Service readiness, 3. Quality of care, and 4. Management and finance.

Countries can choose to implement all or only some of the modules. Core and additional questions allow further flexibility. HHFA implementation requires facility visits to collect data through key informant interviews, observation and/or record reviews. The survey can be carried out as a representative sample of facilities or as a census of all facilities.

The HHFA resource package

The HHFA resource package provides countries with a comprehensive set of downloadable guidance and tools for adapting, planning and implementing a HHFA. Click on the links below to access to the resources.

HHFA quick guide

The quick guide is a summarized version of the comprehensive guide, providing a rapid overview of the key HHFA concepts.

HHFA comprehensive guide

The comprehensive guide describes the HHFA background, rationale, methods and tools, and provides step-by-step guidance for survey planning, implementation, data analysis, interpretation and communication.

HHFA questionnaires

Questionnaires are provided in “stand-alone” and “combined” formats. Stand-alone questionnaires are available for each module. Combined questionnaires integrate the questions from the Availability, Readiness and/or Management and finance modules. Questionnaires can be adapted to the country context.

HHFA CSPro electronic data collection tool

The questionnaires are programmed into a CSPro electronic data collection tool that is used on tablets or mobile phones to collect data in facilities. The tool enables countries to select the questionnaires and questions they want to implement and to adapt the tool to the country context.

HHFA data manager guide

The data manager guide explains how to configure and adapt the CSPro tool to the country context and provides guidance for survey data management and data cleaning processes.

HHFA indicator inventory

An online platform displays all the HHFA indicators, including the survey questions and code needed to calculate each indicator. The inventory can also be downloaded as an Excel document. An indicator tabulation plan can be generated from the indicator platform.

HHFA data analysis platform

After export from the CSPro tool, the HHFA data can be uploaded to a comprehensive online data analysis platform that automatically calculates the HHFA indicators and produces standard tables, graphs and a report outline. The data analysis platform can also be configured to country needs.

HHFA training resources

OpenWHO eLearning courses include: HHFA introduction; Indicators, questionnaires and country adaptation; Data collection training of trainers, Data analysis platform; and Data review, interpretation and communication. Additional resources for country workshops can be downloaded through the eLearning courses.

HHFA OpenWHO eLearning courses

HHFA feedback form

The HHFA resources require regular updates based on evolving standards and lessons learned through country implementation. The feedback form provides an opportunity for anyone using the tools to help us improve the resource package.

HHFA global archive

HHFA and SARA survey reports will be available for download here. Survey metadata and microdata will be accessible in the future, where authorized by the country.

Publications

Harmonized health facility assessment (‎HHFA)‎: quick guide

This short guide aims to provide a quick overview of the Harmonized Health Facility Assessment (HHFA). It summarizes the key technical, planning and implementation...

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Harmonized health facility assessment (‎HHFA)‎: comprehensive guide

The HHFA Comprehensive guide serves as the main reference document for planning and implementing a country HHFA. This guide will promote understanding...

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Harmonized health facility assessment (‎HHFA)‎: data manager guide

The Harmonized Health Facility Assessment (HHFA) is a comprehensive, standardized health facility survey that provides objective information on the availability...

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