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Service Delivery Indicators

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The SDI health surveys are nationally representative, facility-based surveys measuring primary health care service delivery as experienced by the average citizen. They aim to improve the monitoring of service delivery to increase public accountability, good governance, and targeted intervention by assessing quality and performance of health services from the citizen’s perspective.

  • Identify levels and trends in health service delivery from the citizen’s perspective.
  • Identify disparities to learn from high performers and support low-performers with targeted interventions.
  • Create benchmarks for comparison over time for tracking national progress.
  • Generate internationally-comparable metrics for global accountability and learning.

If you are interested in conducting an SDI Health Survey or learning more about the initiative and potential partnerships, please contact us at

Download SDI Health Data: SDI Health Microdata Library



SDI Health Survey Revamp:

The Next Generation of Service Delivery Indicators (SDI) Health Surveys:​ New tools to inform primary healthcare reimagination​

The SDI health survey methodological refresh was driven by a global call-to-action, articulated in three global reports released in 2018, for improving quality of facility-based care to achieve progress towards Universal Health Coverage - Delivering Quality Health Services (2018)The Lancet Global Health Commission on High Quality Health Systems (2018) and Crossing the Global Quality Chasm: Improving Health Care Worldwide (2018). The process included four steps:













Literature review of the latest frameworks for primary health care service delivery, including development of a new framework that builds on the previous onesItem development, drawing on other international survey tools, global standards, and guidelines for quality of care and clinical practice, and ensuring backwards-compatibility with the previous version of the SDIStakeholder consultations with clients in multiple countries to ensure that the design and content are responsive to their policy and program needs, and can be adapted to a given contextExpert consultations with internal World Bank and external academic and research leaders in quality of care to ensure that the tools are of the highest quality


Guiding Framework for the SDI Health Survey

The new framework serves as a primary health care service delivery framework and provides the guiding principles and key domains for the methodological refresh. This framework, which builds on the Primary Health Care Performance Initiative and The Lancet Global Health Commission on High Quality Health Systems in the SDG Era frameworks, defined the scope of the methodological refresh.

Guiding Framework for the SDI Health Survey


Click to view the SDI Health Survey Revamp Fact Sheet, Overview in EnglishFrenchPortugueseSpanish and the Recording


Steps in Implementing an SDI Health Survey

SDI Health Surveys take between 10-24 months to implement, right from the introduction of the survey to the interested World Bank teams and the clients to final report dissemination. This timeline varies from country to country influenced by several factors like time taken by the clients (Ministry of Health representatives) to agree and finalize the objectives of the survey, availability of a sampling frame (a roster of all the health facilities providing PHC services in the country), etc. There are five key stages in implementing an SDI Health Survey (detailed below). The Core SDI Health Survey Team can provide support and guidance at each step:

1. Define

Scope definition and task team orientation (1-2 months)

  • Introduce SDI survey to WB Health Nutrition and Population country team and client (i.e., Ministry of Health representatives)
  • Define the scope, objectives, priorities and timeline of the survey
  • Determine task team composition and clarify roles

2. Design

Survey design and instrument adaptation (2-6 months)

  • Understand national primary health care system architecture and service mandate
  • Define sampling strategy and sample
  • Adapt instruments to fit the country context
  • Finalize logistics for field implementation

3. Implement

Implementation and quality control (2-4 months)

  • Assess the feasibility, risk and performance of the survey tools and team
  • Collect high-quality data, create dataset(s) for analysis

4. Analyze

Data analysis and results validation (4-6 months)

  • Analyze data, compile and validate results
  • Prepare analytical products for dissemination

5. Disseminate

Dissemination and stakeholder consultation (1-2 months)

  • Promote the use of SDI survey data and findings for research, evidence-based policy, accountability
  • Ensure local capacity building for health services and policy research