Table 3.

Selected definitions of quality in WHO HSS building blocks and Individual PHIT Partnerships

	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)