Objective: Although the WHO-developed Service Availability and Readiness
Assessment (SARA) tool is a comprehensive and widely applied survey of
health facility preparedness, SARA data have not previously been used to
model predictors of readiness. We sought to demonstrate that SARA data can
be used to model availability of essential medicines for treating
non-communicable diseases (EM-NCD). Methods: We fit a Poisson regression
model using 2013 SARA data from 196 Ugandan health facilities. The outcome
was total number of different EM-NCD available. Basic amenities,
equipment, region, health facility type, managing authority, NCD
diagnostic capacity, and range of HIV services were tested as predictor
variables. Findings: In multivariate models, we found significant
associations between EM-NCD availability and region, managing authority,
facility type, and range of HIV services. For-profit facilities’ EM-NCD
counts were 98% higher than public facilities (p < .001). General
hospitals and referral health centers had 98% (p = .004) and 105% (p =
.002) higher counts compared to primary health centers. Facilities in the
North and East had significantly lower counts than those in the capital
region (p = 0.015; p = 0.003). Offering HIV care was associated with 35%
lower EM-NCD counts (p = 0.006). Offering HIV counseling and testing was
associated with 57% higher counts (p = 0.048). Conclusion: We identified
multiple within-country disparities in availability of EM-NCD in Uganda.
Our findings can be used to identify gaps and guide distribution of
limited resources. While the primary purpose of SARA is to assess and
monitor health services readiness, we show that it can also be an
important resource for answering complex research and policy questions
requiring multivariate analysis. De-identified SARA
Uganda 2013 database with variables definedSARA Uganda 2013
database with variables used in analysis for this manuscript.
De-identified. Original database is property of Uganda Ministry of
Health.ANALYTIC.SARA-with-variable-list.xlsx