Public Expenditure Tracking Survey in Health 2007, Second Round - Madagascar

Abstract
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The study was designed to assess the effectiveness of spending in Madagascar public health sector. The research evaluated the flow of financial and material resources, medication and wages from central/district to local health facilities. The survey also looked into absenteeism among basic health centers' employees.

The research was conducted in two rounds. The first round was carried out in October-November 2006 and the second round - in April-May 2007. The study was implemented using stratified random sampling. Data from 100 health centers in six provinces was analyzed.

Public Expenditure Tracking Survey in Madagascar primary education sector was conducted at the same time with this research.

Geographic coverage
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Provinces: Antananarivo, Fianarantsoa, Toamasina, Mahajanga, Toliara and Antsiranana.

Analysis unit
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- Centre de Santé de Base/Basic Health Centers;
- Pharmacie à Gestion District/District Pharmacies;
- Service de Santé de District/District Health Authorities;
- Basic Health Centers' employees.

Universe
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The survey covers public basic health centers (CSB), district pharmacies (PhaGDis), district health authorities (SSD) and CSB workers in all six Madagascar provinces.

Kind of data
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Sample survey data [ssd]

Sampling procedure
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The study was conducted using stratified random sampling.

The stratified sample was set up to be representative at the national level. Madagascar has 22 regions and 111 districts, and at least one district was visited in each region. Two districts were selected in the six largest regions. 28 districts were visited in total. The selected districts were obtained through random selection, giving greater (less) weight to districts with more (less) health centers within the district. In each district, three communes were randomly selected.

Two types of health centers - CSB (Centre de Santé de Base/Basic Health Center) Type I and CSB Type II - provide basic health care in Madagascar. In the selected communes, all public health centers of Type II were visited. If public health centers of Type I were present in the commune, one was visited based on random selection.

In the province of Antananarivo 23 public primary health centers were visited, 27 facilities were visited in Fianarantsoa, 19 - in Toamasina, 24 - in Mahajanga, 12 - in Toliara and 8 - in Antsiranana.

In total, 113 health centers were visited. Approximately one-third of the health facilities (35%) were Type I. Due to closure of some health centers during either the first or the second round (or both rounds), researchers ended up with reliable panel data on 100 health centers.

Mode of data collection
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Face-to-face [f2f]

Research instrument
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The following survey instruments are available:

- Enquête au Niveau des Centres de Sante, Visite 1er Jour;
- Enquête au Niveau des Centres de Sante, Visite 2ème Jour;
- Enquête au Niveau des Centres de Sante de Base, Enquete Personnel;
- Enquête au Niveau des Centres de Sante, Enquete Phagdis;
- Questionnaire auprès des S.S.D.

In order to accurately investigate the resource flows through the different decentralized facility levels, surveys were organized at PhaGDis (Pharmacie à Gestion District/District Pharmacy) and CSB (Centre de Santé de Base/Basic Health Center) levels. At CSB level, the director was interviewed independently from the rest of the staff. To ensure compatibility, the surveys were organized at the same time. The discrict health authorities (SSD) questionnaire was administered during the second round.

Cleaning operations
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Detailed information about data editing procedures is available in "Data Cleaning Guide for PETS/QSDS Surveys" in external resources.

STATA cleaning do-files and data quality reports can also be found in external resources.

摘要
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本研究旨在评估马达加斯加公共卫生部门投入的有效性。研究评估了中央/区级至地方卫生机构之间财政和物资资源、药品及工资的流动情况。调查还考察了基层卫生中心员工出勤率问题。
研究分两轮进行。首轮于2006年10月至11月进行，次轮则于2007年4月至5月实施。研究采用分层随机抽样方法。分析了六个省份的100个卫生中心的数据。
与此同时，马达加斯加公共支出追踪调查在初等教育部门也同步进行。
地理覆盖范围
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省份：塔那那利佛、菲亚纳兰达、塔马塔夫、马哈贾加、托利阿拉和安齐兰纳。
分析单元
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- 基层卫生中心 (Centre de Santé de Base/Basic Health Centers);
- 区级药房 (Pharmacie à Gestion District/District Pharmacies);
- 区级卫生机构 (Service de Santé de District/District Health Authorities);
- 基层卫生中心员工。
总体
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该调查覆盖了马达加斯加六个省份的所有公共基层卫生中心 (CSB)、区级药房 (PhaGDis)、区级卫生机构 (SSD) 和基层卫生中心工作人员。
数据类型
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样本调查数据 [ssd]
抽样程序
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本研究采用分层随机抽样方法。
分层样本旨在在全国范围内具有代表性。马达加斯加有22个地区和111个区，每个地区至少访问一个区。在六个最大地区中，各选择了两个区。总共访问了28个区。选定的区通过随机选择获得，对区内拥有更多（较少）卫生中心的区给予更多（较少）权重。在每个区，随机选择了三个市镇。
马达加斯加在基层提供基本卫生保健的两种类型的卫生中心 - 基层卫生中心（CSB）I型和CSB II型。在选定的市镇中，访问了所有公共卫生中心II型。如果市镇存在公共卫生中心I型，则根据随机选择访问其中一家。在塔那那利佛省，访问了23家公共初级卫生中心，在菲亚纳兰达访问了27个设施，在塔马塔夫访问了19个，在马哈贾加访问了24个，在托利阿拉访问了12个，在安齐兰纳访问了8个。
总共访问了113个卫生中心。大约三分之一的卫生机构（35%）为I型。由于一些卫生中心在第一轮或第二轮（或两轮）关闭，研究人员最终获得了关于100个卫生中心的可靠面板数据。
数据收集方式
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面对面 [f2f]
研究工具
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以下调查工具可供使用：
- 卫生中心水平调查，第一天访问；
- 卫生中心水平调查，第二天访问；
- 基层卫生中心水平调查，个人调查；
- 卫生中心水平调查，Phagdis调查；
- SSD问卷调查。
为了准确调查通过不同分权设施层级资源流动，调查在区级药房（PhaGDis）和基层卫生中心（CSB）水平组织。在基层卫生中心水平，主任独立于其他员工接受采访。为确保兼容性，调查同时组织。区级卫生机构（SSD）问卷在次轮进行。
数据清理操作
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有关数据编辑程序详细信息的指南可在外部资源中找到“PETS/QSDS调查数据清理指南”。
STATA清理do文件和数据质量报告也可在外部资源中找到。