Missing Billion Facility Level Assessment
Measuring and improving the accessibility of health facilities was one of the main recommendations of the second Missing Billion Report. We have developed a new tool and accompanying menu of interventions to help Ministries of Health and individual health facilities measure, understand, and improve their accessibility. The Facility Level Assessment (FLA) adapts the Disability Awareness Checklist developed by the South African Medical Research Council to include refined components and indicators, specific measurements, scoring, and a menu of interventions to measure and improve the accessibility of health facilities.
The FLA covers six thematic areas across the patient journey:
Communication before arriving at a facility
Entrance to services
Reception, corridors, and rooms
Reasonable accommodation, communication and assistance
Health worker training
Receiving treatment and follow-up care
The FLA tool and menu of interventions are designed to be easy to use by non-experts, such as health facility leaders or staff. The process begins with a pre-assessment of key stakeholders (including people with disabilities and OPDs) and kick-off events to mobilize support for the assessment. We estimate that the assessment itself takes about 1 week to complete, including coordinating the facility visit and collecting the relevant data points (i.e., measuring doorways, checking tactile pavement etc.). Afterwards, individuals should plan for 2-3 months to review their reports, plan and implement interventions, and monitor the progress and impact of the interventions. You can download a high-level overview of the FLA tool below.