Table 3.
Service delivery | Health Workforce | Information | Medical Products, Vaccines, & Technologies | Financing | Leadership and governance | |
---|---|---|---|---|---|---|
WHO [1] | Coverage, comprehensive accessibility continuity, person-centeredness coordination, accountability and efficiency General and specific service readiness score 1 |
Health worker distribution* | Performance of specific surveys and other health measurements Facility reporting Data quality (through Data quality audits: DQA) |
Availability of tracer drugs* | National expenditure of health Out of pocket expenditures Insurance coverage |
Presence of relevant strategies and guidelines |
Ghana [12] | Quality of care delivered by CHWs Patient satisfaction Community satisfaction (care (availability, perception of quality) |
Full complement of staff per facility Supervision of CHWs by DHMTs |
Effective use of data to drive appropriate allocation and care delivery Data quality (concordance) |
Availability of tracer drugs and other commodities | Allocation of project funds reflective of identified needs | Leadership capacity Data-driven allocation of funds |
Mozambique [16] | Timeliness of primary health care service provision Patient satisfaction Population coverage Service integration |
Efficiency in the allocation of trained health workers Availability of trained health workers. Frequency of supervision visits (facility and district). |
Data quality (through DQA) | Availability of tracer drugs and other commodities | Equity of funding distribution across districts Public sector capacity for management of project funds Financial management capacity |
Availability of trained district and facility management personnel Frequency of management meetings (district and facility) |
Rwanda [10] | Quality of care delivered Service volume Population coverage (equity; effective coverage) |
Facility staffing Staff training HCW retention and satisfaction Receipt of supervision |
Data quality (focus on health facility and CHW registries) Internet/network downtime Utilization of facility data for management decisions |
Appropriate equipment levels Availability of tracer drugs and other commodities Strength of district supply chain management Availability of selected lab capacity |
Insurance coverage Costing of services delivered Public sector management of project funds |
Utilization of data to drive improvement |
Tanzania2[11] | Availability of selected services, Outreach performed for care Quality of care |
Staff training Facility staff levels Receipt of supervision Performance of QA activities |
Required routine data reports submitted | Availability of tracer drugs and other commodities Availability of selected lab capacity |
Meetings at Health Facility to discuss management and governance | |
Zambia [8] | Quality of care delivered Service readiness Guideline availability at site Community reported utilization of selected health services |
Density, motivation and training of health workers | Data quality and record keeping | Availability of selected tracer drugs and other commodities | Financial planning capacity and activities Public sector management of project funds Geographic equity of funding allocation |
Facility governance (self-rated) Community participation in health service delivery and perceived appropriate governance Funding allocation and activities reflecting identified gaps |
WHO: World Health Organization; CHW: community health workers; DHMT: District Health Management team; QA: Quality Assurance
*chosen as core measures across all PHIT projects
1 Includes drugs and commodities infrastructure, (basic amenities), basic equipment, laboratory, infection control and specialized services
2 Also used principal component analysis to convert data from MACRO Service Provision assessment tool (SPA) into composite indices of health system strength (e.g. readiness to provide curative care, readiness to provide preventive care, readiness to provide advanced clinical care)