The Quality of Health and Education Systems Across Africa
with the SDI measurement approach and are useful for organizing the presentation of SDI analytical work. To date, SDI surveys have primarily measured physical inputs and provider characteristics and have been more limited in the measurement of user characteristics and outcomes. The SDI initiative has recognized a pending agenda to measure the quality of management and other key drivers of service quality (see chapter 4).
Aims and structure of the book This book documents lessons learned from a decade of SDI surveys.3 The surveys provide a nuanced view of the state of health care and education systems across Africa, showing both remarkable successes in certain aspects and the ongoing need for strengthening and revitalization in others. The book highlights the variation within and between countries, documenting how widely health care and education services may differ, depending on where they are sought, and offers elements for reflection on how health and education systems could be improved in a post-COVID-19 world. Chapter 2 presents results from the SDI health surveys, with a focus on what the SDI surveys reveal about the current state of primary health care. It provides data on some of the most common obstacles and facilitators that patients face in seeking care, such as the availability of medicines or provider knowledge of common outpatient conditions. The discussion emphasizes the breadth of experience within countries and attempts to identify entry points to improve the provision of health care. Chapter 3 discusses evidence from the SDI education surveys, which add a further dimension of measurement: learning outcomes, which can be analyzed in connection with teacher and school characteristics. The SDI education results highlight the substantial heterogeneity within and between schools and across countries, with interesting lessons to be derived from the comparison of public and private schools and the analysis of characteristics that distinguish the best- from the worst-performing schools. The world of measurement is changing, and SDI surveys are changing with it. Measurement innovations in SDI surveys are discussed in chapter 4. Although the initiative began in Africa, SDI surveys have now expanded around the globe and continue to evolve in both content and form. Some changes have been guided by country-specific needs and evolving policy priorities, whereas other changes are premised on a need to understand the context in which health and education services are used. This richer contextual view expands the focus beyond the facility itself. This chapter details ongoing innovations and discusses the future goals of the SDI initiative.
14
