(last update: 2022-06-08 15:25:23)
Note:
* Indicator estimates from multiple surveys are combined/appended and then saved in one Excel file as well as multiple Stata data files in the sharepoint: “/BANICA, Sorin - HSA unit/4 Databases, analyses & dashboards/2 HFAs for COVID-19/HFA database/1 Database"
* This analysis uses the Stata data files (downloaded as of 2022-06-08 18:21:00 CET). Analysis code will be saved in the sharepoint:”/BANICA, Sorin - HSA unit/4 Databases, analyses & dashboards/2 HFAs for COVID-19/HFA database/2 Analysis files/HFA database"
* C19CM data are available for 22 surveys from 18 countries.
* CEHS data are available for 26 surveys from 21 countries.
* COMMUNITY data are available for 19 surveys from 17 countries.
See here for implementation results, including sample size information
See here for data quality check
xspcmitem_score: Average specimen collection items score (range: 0-100), among all facilities
xrdt_capacity: Average current testing load out of maximum capacity (%), Among those that conduct RDT tests onsite
xpcr_capacity: Average current testing load out of maximum capacity (%), among those that conduct PCR tests onsite
xdiagcovid_score: Average COVID diagnosis score (range: 0-100), among all facilities
xdrug_score: Average medicines score (range: 0-100), among all facilities
xsupp_score: Average supplies score (range: 0-100), among all facilities
xequip_anyfunction_score: Average equipment score, any quantity functioning (range: 0-100), among all facilities
xequip_allfunction_score: Average equipment score, all quantity functioning (range: 0-100), among all facilities
Note: Do further analysis of “scores” by IMST status. If no difference, consider dropping the questioins.
ybed: Total pooled number of inpatient beds
ybed_cap_covid: Total pooled number of inpatient beds that can be used for any COVID-19 patients
ybed_cap_covid_severe: Total pooled number of inpatient beds that can be used for severe COVID-19 patients (not requiring intensive care)
ybed_cap_covid_critical: Total pooled number of inpatient beds that can be used for critical COVID-19 patients (requiring intensive care)
ybed_cap_noncovid: ybed - ybed_cap_covid
ybed_cap_respiso: Total pooled number of inpatient beds that can be used for respiratory isolation
ybed_covid_night: Total pooled number of inpatient beds currently occupied by confirmed/suspected COVID-19 patients (Average over two days)
ybed_convert_respiso: Total pooled number of inpatient beds that can be converted for respiratory isolation, if needed
ybed_convert_icu: Total pooled number of inpatient beds that can be converted for ICU, if needed
A good example that interpretation requires COVID-19 transmission context.
- Kenya R2 & Zambia R1 were conducted in the middle of an outbreak - post-peak, when hospitalizations would have peaked….
- Ghana R1 was done during the low phase, right before an outbreak/peak.
| survey | ybed | ybed_icu | ybed_cap_covid |
|---|---|---|---|
| AFG_R1 | 300 | 66 | 300 |
| BDI_R1 | 7225 | 312 | 206 |
| CMR_R1 | 6200 | 404 | 970 |
| COG_R1 | 2302 | 845 | 276 |
| GHA_R1 | 5331 | 168 | 1029 |
| GHA_R2 | 6665 | 197 | 541 |
| KEN_R1 | 16128 | 504 | 3597 |
| KEN_R2 | 17341 | 660 | 3821 |
| KEN_R3 | 19130 | 705 | 4098 |
| LBY_R1 | 3997 | 843 | 689 |
| LCA_R1 | 130 | 50 | 130 |
| MLI_R1 | 2689 | 145 | 521 |
| NAM_R1 | 6763 | 166 | 1362 |
| PER_R1 | 8823 | 679 | 3653 |
| PRY_R1 | 2164 | 242 | 1011 |
| SEN_R1 | 3085 | 238 | 442 |
| SUR_R1 | 1637 | 71 | 458 |
| TCD_R1 | 416 | 16 | 6 |
| VCT_R1 | 210 | 5 | 34 |
| YEM_R1 | 832 | 393 | 788 |
| ZMB_R1 | 9128 | 176 | 1405 |
| ZMB_R2 | 9549 | 279 | 1495 |
Note: Cameroon: ybed_cap_covid >> ybed_cap_respiso. French Q tanslation issue or health systems difference? “ybed_cap_respiso” is an odd/unclear indicator.
xppe: % of facilities that provide PPE to staff
xppe_allsome_100: % of facilities that have each of all 6 tracer PPE items currently available for all or some staff
xppe_allsome_50: % of facilities that have 50% or more of the tracer items
xppe_all_100: % of facilities that have each of all 6 tracer PPE items currently available for all staff
xxppe_all_100: % of facilities that have each of all select three tracer PPE items (mask, respirator, and gloves) currently available for all staff
xppedispose: % of facilities that dispose used PPE safely according to the IPC guidelines
xequip_allfunction_100: % of facilities that have all tracer items, all quantity functioning
xequip_allfunction_50: % of facilities that have 50% or more of the tracer items, all quantity functioning
xequip_anyfunction_100: % of facilities that have all tracer items, any quantity functioning
xequip_anyfunction_50: % of facilities that have 50% or more of the tracer items, any quantity functioning
xxequip_anyfunction_100: % of facilities that have all specific tracer items (LIST THEM HERE), any quantity functioning
Note: availability of any functioning ventilators (invasive and non-invasive) is sub-optimal. Even if they exist and functional, we do not know if the number of ventilators can address an outbreak.
**xequip_allfunction__xray**: % of facilities that have all available quantity functioning X-ray machines
**xequip_allfunction__oximeters**: % of facilities that have all available quantity functioning pulse oximeters
**xequip_allfunction__vent_icu**: % of facilities that have all available quantity functioning ventilators for ICU
**xequip_allfunction__vent_noninvasive**: % of facilities that have all available quantity functioning non-invasive ventilators
**xequip_anyfunction__xray**: % of facilities that have any available quantity functioning X-ray machines
**xequip_anyfunction__oximeters**: % of facilities that have any available quantity functioning pulse oximeters
**xequip_anyfunction__vent_icu**: % of facilities that have any available quantity functioning ventilators for ICU
**xequip_anyfunction__vent_noninvasive**: % of facilities that have any available quantity functioning non-invasive ventilators
xoxygen_concentrator: % of facilities that have: oxygen concentrator
xoxygen_bulk: % of facilities that have: external supply bulk
xoxygen_cylinder: % of facilities that have: external supply oxygen cylinders
xoxygen_plant: % of facilities that have: oxygen generator plant
xoxygensource: % of facilities that have: any of the FOUR sources
xoxygen_dist: of facilities that have piped oxygen distribution to terminal bedside wall units
xoxygen_portcylinder: % of facilities that have a portable medical gas cylinder for oxygen, which is fitted with a valve, a pressure and flow regulator?
Note: internally consistent - generally.
But, what is the difference between xoxygen_cylinder vs. xoxygen_portcylinder? The relationship is different in Kenya R2. Data error/different interpretation or actual difference?
oxygen availability is universally good, though distribution is low (no immediate intervention possible for this).
Note:
* staff absence is common (expected?), but they are not necessarily for COVID related reasons (as reported by respondents/manager).
* See increase/shift in reasons in Kenya, reflecting burn out as the pandemic prolongs?.
xppe: % of facilities that provide PPE to staff
xppe_allsome_100: % of facilities that have each of all 6 tracer PPE items currently available for all or some staff
xppe_allsome_50: % of facilities that have 50% or more of the tracer items
xppe_all_100: % of facilities that have each of all 6 tracer PPE items currently available for all staff
xxppe_all_100: % of facilities that have each of all select three tracer PPE items (mask, respirator, and gloves) currently available for all staff
xppedispose: % of facilities that dispose used PPE safely according to the IPC guidelines
What do we do/act with this data? Does every facility need to have a referral facility??? what does that mean, if/when patient volume surges?
Note: different definition in Kenya R1 .
xcvd_pt, indicating different health systems/coordination for COVID patients management across countries.xcvd_pt: % of primary-level facilities that have seen patients with suspected COVID-19 in the past 3 months
xcvd_pt_sep_room: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Patient consultation takes place in a separate room
xcvd_pt_c19_check: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Checked for COVID-19 symptoms
xcvd_pt_o2_measure: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Measured O2 saturation with pulse oximeter
xcvd_pt_refer: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Referred the patient to specialized care
xcvd_pt_diagtest: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Performed diagnostic test
xcvd_pt_home_isolate: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Instructed patients with mild symptoms to self-isolate at home
xcvd_pt_tele: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of primary-level facilities that performed: Provided teleconsultation to answer patient’s questions before facility visit
xcvd_pt_score: Average score for COVID-19 patients management based on the tracer items (range: 0-100), among primary-level facilities that had COVID-19 patients in the past 3 months
xcvd_pt_100: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of facilities that have performed all seven tracer items for management of COVID-19 patients
xcvd_pt_50: Among primary-level facilities that had COVID-19 patients in the past 3 months, % of facilities that have performed 50% of tracer items for management of COVID-19 patients
Note: Ghana should drop these xcvd_pt questions. Too small denominator.
xcvd_pthbsi: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients
xcvd_pthbsi_tele: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients AND: Provided remote consultation (phone or video call, text message)
xcvd_pthbsi_homevisit: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients AND: Visited patients at home
xcvd_pthbsi_followup: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients AND: Arranged follow-up visit to the facility (e.g. by asking the patient to report to a designated entrance at prearranged appointment time)
xcvd_pthbsi_safetyinstruct: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients AND: Provided safety instructions for the members of the patient’s household
xcvd_pthbsi_complianceassess: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients AND: Assessed compliance with self-isolation
xcvd_pthbsi_report: % of primary-level facilities that have instructed home isolation for mild COVID-19 patients AND: Reported the home-based self-isolation and care patients to relevant health authority
xcvd_guide_casemanage: % of primary-level facilities that have received up-to-date guidelines to manage asymptomatic or mild COVID-19 cases, including for referral
Note: Ghana should drop these xcvd_pthbsi questons. Too small denominator.
Note: in CMR, “other” is the major source. What are they?
xcovax: % of facilities that provide COVID-19 vaccine
**xcovax_offer__pfizer**: Among facilities that provide COVID-19 vaccine, % of facilities that offer vaccine 001
**xcovax_offerav__pfizer**: Among facilities that provide COVID-19 vaccine, % of facilities that offer and have vaccine 001
**xcovax_offer__moderna**: Among facilities that provide COVID-19 vaccine, % of facilities that offer vaccine 002
**xcovax_offerav__moderna**: Among facilities that provide COVID-19 vaccine, % of facilities that offer and have vaccine 002
**xcovax_offer__astra**: Among facilities that provide COVID-19 vaccine, % of facilities that offer vaccine 003
**xcovax_offerav__astra**: Among facilities that provide COVID-19 vaccine, % of facilities that offer and have vaccine 003
**xcovax_offer__jj**: Among facilities that provide COVID-19 vaccine, % of facilities that offer vaccine 004
**xcovax_offerav__jj**: Among facilities that provide COVID-19 vaccine, % of facilities that offer and have vaccine 004
See the gap between “offer” vs. “available” (% point difference).
xcovax_syr: Among facilities that provide COVID-19 vaccine, % of facilities that syringes
xcovax_sharp: Among facilities that provide COVID-19 vaccine, % of facilities that have sharps containers
xcovax_strtemp: Among facilities that provide COVID-19 vaccine, % of facilities that have cold storage for COVID-19 vaccine remaining in the recommended temperature range, currently
xcovax_strtemp_w: Among facilities that provide COVID-19 vaccine, % of facilities that have cold storage for COVID-19 vaccine remaining in the recommended temperature range, currently AND for the past week
xcovax_aefikit: Among facilities that provide COVID-19 vaccine, % of facilities that have AEFI kit
xcovax_aefireport: Among facilities that provide COVID-19 vaccine, % of facilities that have system to report AEFI to the central center
See cold chain issues in GHA.
Missing aefi data - why??
Reported training is universally high. Probably not reporting bias, since the vaccine is brand new.
(Facilities can provide multiple strategies.)
Note: reflection of various context. no benchmark. requires context specific interpretation.
* Makes sense that Ukraine looks different from others. See remote and prescription.
* Very few closure. Mostly reduced hours. Scope reduction is not common. Meaning service availability did not change drastically - especially for priority patients.
xopt_increase: % of facilities that have had increased outpatient attendance in the past 3 months in one or more of the 18 services listed
xopt_increase_reason_covidnow: % of facilities that have had increased outpatient attendance in the past 3 months AND cited reasons reflecting current outbreak
xopt_increase_reason_covidafter: % of facilities that have had increased outpatient attendance in the past 3 months AND cited reasons reflecting impact of past outbreak
xopt_increase_reason_gbv: % of facilities that have had increased outpatient attendance in the past 3 months AND cited reasons reflecting GBV
xopt_decrease: % of facilities that have had decreased outpatient attendance in the past 3 months in one or more of the 18 services listed
xopt_decrease_reason_comdemand: % of facilities that have had decreased outpatient attendance in the past 3 months AND cited reasons reflecting community demand changes
xopt_decrease_reason_enviro: % of facilities that have had decreased outpatient attendance in the past 3 months AND cited reasons reflecting barriers in care seeking
xopt_decrease_reason_intention: % of facilities that have had decreased outpatient attendance in the past 3 months AND cited reasons reflecting changes in service provision strategies
xopt_decrease_reason_disruption: % of facilities that have had decreased outpatient attendance in the past 3 months AND cited reasons reflecting disruption at the facility level
(Facilities can provide multiple reasons.)
xopt_increase and xopt_decrease would be yes in most facilities, unless they are specialized in particular services (which should not be part of the EHS sample anyway, in theory)Similar indicators:
* In section 7, __xdisrupt_supply**: % of facilities that reported service disruption due to supply stock out (potentially leading question)
* In section 4, __xopt_decrease_reason_disruption**: % of facilities that have had decreased outpatient attendance in the past 3 months AND cited reasons reflecting disruption at the facility level
xer: % of facilities providing emergency unit services
xer_increase: Among facilities with emergency unit, % of facilities that have had overall increased emergency unit visits in the past 3 months compared to the same months last year
xer_decrease: Among facilities with emergency unit, % of facilities that have had overall decreased emergency unit visits in the past 3 months compared to the same months last year
xer_nochange: Among facilities with emergency unit, % of facilities that have had overall no changes in emergency unit visits in the past 3 months compared to the same months last year
**xer_increase__002**: Among facilities with emergency unit. % of facilities that have had increased emergency unit visits for injuries in the past 3 months
**xer_increase__003**: Among facilities with emergency unit. % of facilities that have had increased emergency unit visits for emergency surgeries in the past 3 months
**xer_increase__004**: Among facilities with emergency unit. % of facilities that have had increased emergency unit visits for NCD related conditions in the past 3 months
**xer_increase__005**: Among facilities with emergency unit. % of facilities that have had increased emergency unit visits for emergency blood transfusion services in the past 3 months
**xer_decrease__002**: Among facilities with emergency unit. % of facilities that have had decreased emergency unit visits for injuries in the past 3 months
**xer_decrease__003**: Among facilities with emergency unit. % of facilities that have had decreased emergency unit visits for emergency surgeries in the past 3 months
**xer_decrease__004**: Among facilities with emergency unit. % of facilities that have had decreased emergency unit visits for NCD related conditions in the past 3 months
**xer_decrease__005**: Among facilities with emergency unit. % of facilities that have had decreased emergency unit visits for emergency blood transfusion services in the past 3 months
xout: % of facilities that provide community outreach or home-visit services
**xout_decrease__immun**: Among facilities providing community outreach or home-visit services, % of facilities that have reduced or suspended: Immunization outreach
**xout_decrease__malaria**: Among facilities providing community outreach or home-visit services, % of facilities that have reduced or suspended: Malaria prevention campaigns, including distribution of ITN
**xout_decrease__ntd**: Among facilities providing community outreach or home-visit services, % of facilities that have reduced or suspended: Neglected tropical disease outreach activities, including mass drug administration
**xout_decrease__cbc**: Among facilities providing community outreach or home-visit services, % of facilities that have reduced or suspended: Community-based mobile clinics
**xout_decrease__home**: Among facilities providing community outreach or home-visit services, % of facilities that have reduced or suspended: home visits
xout_decrease: Among facilities providing community outreach or home-visit services, % of facilities that have reduced or suspended one or more of the five services (see below) in the past three months
xresto: % of facilities that have developed plans to deliver services for patients who missed their routine appointments that are unrelated with COVID-19 in the previous 3 months AND registered them
xresto_imp_preg: Among facilities that provide ANC, % of facilities that have implemented plans for targeted catch up for pregnant women who missed appointments in the past three months
xresto_imp_immunization: Among facilities that provide child immunization, % of facilities that have implemented plans for targeted catch up for missed appointments for childhood immunization
xresto_imp_chronic: Among facilities that provide NCD, % of facilities that have implemented plans for targeted catch up for chronic non-communicable diseases patients who missed appointments in the past three months
xresto_imp_tb: Among facilities that provide TB, % of facilities that have implemented plans for targeted catch up for TB patients who missed appointments in the past three months
xresto_imp_hiv: Among facilities that provide HIV, % of facilities that have implemented plans for targeted catch up for HIV patients who missed appointments in the past three months
xresto_imppln_preg: Among facilities that provide ANC, % of facilities that have developed or implemented plans for targeted catch up for pregnant women who missed appointments in the past three months
xresto_imppln_immunization: Among facilities that provide child immunization, % of facilities that have developed or implemented plans for targeted catch up for missed appointments for childhood immunization
xresto_imppln_chronic: Among facilities that provide NCD, % of facilities that have developed or implemented plans for targeted catch up for chronic non-communicable diseases patients who missed appointments in the past three months
xresto_imppln_tb: Among facilities that provide TB, % of facilities that have developed or implemented plans for targeted catch up for TB patients who missed appointments in the past three months
xresto_imppln_hiv: Among facilities that provide HIV, % of facilities that have developed or implemented plans for targeted catch up for HIV patients who missed appointments in the past three months
Percent of communities where most/some people are concerned about COVID-19
Percent of communities where most people would receive COVID-19 vaccine
no concern
1. Not concerned about getting infected with COVID-19
concerns about covid vaccine
2. Uncertain if the COVID-19 vaccine will be effective
3. Concerned about side-effects of the COVID-19 vaccine
concerns about exposure
4. Do not want to go to facilities for fear of getting infected with COVID-19
concerns about vaccine
5. General mistrust of or opposition to any vaccine
time
6. Too busy to get vaccinated
const
7. Concerned about cost
Note: the difference between COVID-19 vaccine specific concerns and general concerns about vaccine suggests potential target groups and interventions.
Missing data in Kenya - why??
Unmet need distribution among people who have specific condition/need (Individual)
Q3.2: “During the COVID-19 pandemic, would you say people’s experience in getting health care has generally remained stable, been moderately affected, or been strongly affected? This refers to any type of health services, not only COVID-19 care.”
CHW: either the most or one of the most cited source - how much of this is bias? if true, what do the results mean?
xknowledge: Yes to Q6.1: “Do you feel confident in your knowledge about COVID-19?”
xrisk_mode: moderate OR high
xrisk_high: high