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Abstract The purpose of this part of the final report is to Int rodoce toe backgr o.:m<1.,. concept.s , •md proced ures ’of the ECffij{ Urban Health Sector Assessment Project. and to present II sU!I1OO.ry of findings, conclusions and reCOll1!llendlilo,ns. The Urban Heal th secror Assessment (lllSA - the Study) was conducted by the Health Services Research Group of the ~perjlllental Center for Traini.ng Evaluation of Social Programs (OCTOR). II research COOlsuHatiton group located in the Inst l ture of Natioo”l Planning. in Egypt. The Stud)’ is part of t’ile Egyptian Ministry of I!ealth’s Urban Health Deliver)’ Project (lim&’- the Project), funded by USAlD in Cairo. ThelJIDp is desi$lled to modify ami upgrade Cairo ’5 existing maternal and Child health and family planning services delivery system. Specifically, the Project responds to the health needs of low-im:,ome groups, particularly women of chj]d bening age MO children under six years of age. The ~ISA study is intended to provide information useful to the lJ-IDP in its planniJl\g/services 1l11prol’ement component. ’The Study ••·•as funded by USAID in February. 198’0. Project illJPlelllentHion began in May of that year, and was completa’l in OCtober. 1982. Phase n. including design of methods. data collection & anal)’s is & report preparat ion was of less than one year’s duration. The original rationale for the study, as stated ill the USAJD Project Paper. was’ t.o fulfull ”the need for undert.aking a hedth sector assessment for the greater CBJiro area to provide a more scienti fic base for planning the health service deli very system ••.•• (and) to help rationalite heal til services wi thin these areas.” It was also intended to introduce and eventually institutionalize health servfces research as one llIeans of imprQvjng health services delivery in Egypt. The purpose of the 2.S year llISA study was to provide information useful to the UlHDP and the Min.istry of Health in its planning/service illlprollement component. The ltlSA Study was conducted in two phases in three zones of Cairo: Helvan South and ~est Cairo. (See l-laps 1, 2• .3 tor study areas. ) Phase J of the study, conducted in fiebt.m , .•a••s a • z - pi lot test of bot” research lllethods and an OI’l1.anlzational approach to conducting socha comprehensive hC<llth needs as sessmerrt study in EgYl~t. Phase 11 was designed based on ltnQwlcdge gained in HeJwan. 1hc prilllilry research question, focusiN! on maternal<tlld child health, was: ”Who goes to what health care SOUTce, for ”,1’I;l.t ·teason, to receive what service, at ••bat <::ost1” . 1Ms question was used as the basis for design of the study methods and data collection instnments. It was derived from the objectives of the WSA stl)dy, as stated in the contract scope of ’’’lark, ”nd frQlll the results of Phase· I. ’The study objectives, aad their relationship to the metlloos used io iIIlplernenting the project. are shown in Table 1.1- In PhasE: J, a nlJnber of both traditional ana innovat i•e•.. data collection and Foil sea rch management methods .•e..r.e desj !J,I1ed and tested. The intent W~$ to develop metnods and data that could ulti.m;;tely be used by the Ninistry of Health in planning health care policy ana progT<IJII$. ’Iberefore, the methods had to be replicable, and of reJa.twely 10’i<l cost and short duration. Deta iIed records were kept of the implet~lmtatioo process, in order to assess the feasibility, utility, and appropriateness of the metkods used, 111.05’e records provide an illoV:!Iloable set of” data for use by the Mi~jst~ of Health and AID in planning nealth services research projects in El::ypt. (Refer to the project documents HSA/SR/Ol through HSA/SR/l~.) Furthermore, 81gn if icant; data were collected on these aspects of 1He in i1elwan that Could relate to health care systems del’very and utilization of Maternal snd Child Health (~’CH) serv ices in that area. Additional important find i ngs also included health care needs Md treatment behavior of the population, service deli very patterns, and accessibility. (see: especially documents HSA/SRJO:5, (14 and 11 fordeUils of Phase I in Helwan.) SUbsequent to data col Iect ion and analysis for Helwan. an extensive review was Inade of the methods and stud)’ ()r~anhation. and the research design for South ,lind !II’est Cllro ”’3S devet oped based 0)1, tho exper iences in Helwan. The target group (mothers of ddld-bea;rin~ a1e, and children of six yeats and younger) rem3il’led the same, as did assessment of the health care delhN~ry system pertinent to the target group. l1owever, the methodoLogy was revised in two lllajor ways: 1. fA contour approach was adapted for the two geographic areas sefected for study in ”Phase II: lind 2.. The eleven task force groups were rcpl<lced by a single multidisciplinary team. See Part 1I Methodology far an overview of Ph.ase I approaches and for Phase n methods lind approaches. FOCI ,of Interest the study had several interrelated foci of interest: I) providers fheafth workers} who deliver health services in the formal lliJld Informal systems; 2) clients lIIho, use the services provided through the fomal and in.formal health services delivery systems~ 3) the community at large, including bealth services users and non-users livini in the particular sccto-econcenc, sccic-cul tura l , and urban-envi ronmental setting under study; and 4) the hl!81th services and technologies available in each of the f••ci lit.ies under study. Bach of the groups and individuals provides or lilt UizeS· the health care 5yst.em according to their background chaTact.e’fistics (e.g., socto-econcedc and demographic facrers), and the environmental conditions in which they live and/or work. cne basic research question is: what are the characteristics and conditions of the target groups , and how do they affect health service deliver-y!utilh.ation? Th.C potential and actual client.s and providers are pIIrt of an interactive system whose study am yield infordation that can be ~sed to improve health services delivery such that the health needs of the target group are met. The~. study was used to collect and anal~e data regarding: Socio-ec;:onomic., deracgraphic and attitudinal characteristics to construct a profile ,of th,8 target population (clients) and the proltiders |