Developing core and expanded indicators

Work to develop the core and expanded indicators begun in September 2015. The monitoring task team held a series of teleconferences between October 2015 and May 2016 to propose indicators and questions that are based on global norms and look at existing questions in multi-national surveys and national monitoring systems (e.g. the WHO Service Availability and Readiness Assessment, the World Bank’s Service Delivery Indicators, and the USAID-supported Service Provision Assessment). The task team proposed a set of draft service ladders, core and expanded indicators and questions which were discussed at a small Expert Group Meeting in New York in June 2016.  The core indicators have been finalised and can be used to align surveys and questionnaires with SDG monitoring. The expanded indicators need to be revisited and this work will be done in Q2-3 2017. 

Note, at present, all indicators are for outpatient settings. Work is underway to develop a set of indicators for maternity settings. 

FINAL Core WASH in HCF indicators and service ladders (November 2016).

Meeting report: Expert Group Meeting on Monitoring WASH in Health Care Facilities in the Sustainable Development Goals


If you would like to be involved in this work stream, use the indicators in a survey, or provide feedback on any of the indicators, please send an email to washinhcf(at)who(dot)int.  


Monitoring tools

Service Availability and Readiness Assessment (SARA)
SARA is designed to assess service delivery including the service availability mapping (SAM) tool developed by WHO, and the service provision assessment (SPA) tool developed by ICF International

Service Delivery Indicators (SDI)
SDI is a new Africa-wide initiative from the World Bank that collects actionable data on service delivery in schools and health facilities. The SDI data are used to assess the quality and performance of education and health services for decision makers to track progress over time, and for citizens to hold governments accountable for public spending.

Service Provision Assessment (SPA)
USAID's SPA is a health facility assessment that provides a comprehensive overview of a country’s health service delivery and fills an urgent need for monitoring health system strengthening in developing countries.  They collect information on the overall availability of different facility-based health services in a country and their readiness to provide those services

Primary Health Care Performance Initiative
PHCPI is a collaboration of the Bill & Melinda Gates Foundation, the World Bank and the World Health Organization and will support countries to strengthen monitoring, tracking and sharing of key performance indicators for primary health care. While many countries have identified primary health care as an urgent priority, they lack the data needed to pinpoint weaknesses, understand their causes and drive improvements.