Table 2.

Assessment of exposure to intervention, key intermediate mechanisms (commitment and efficacy), and outcomes of the 10 talukas of Tumkur

	Classroom participation 1	Mentoring 2	Retention of mentoring 3	Organizational commitment 4	Self-efficacy 5	Supportive supervision 6	Intention to change 7	Stability of team 8	Net change in budget utilisation 9	Net change in CS rate 10	Net change in stillbirth rate 11	Development index 12
Gubbi	0.7	0.7	High	AC 2.66	68	2.5	50	Moderate	2	1	-16	0.95
				NC 2.47
				CC 2.42
Tumkur	0.7	0.7	Moderate	AC 2.85	68	2.6	75	Low	6	1.5	-8	1.21
				NC 2.46
				CC 2.69
CN Halli	0.6	0.5	Moderate	AC 2.75	70	2.2	100	High	4	0.1	0	1.02
				NC 2.29
				CC 2.71
Turuvekere	0.6	0.4	Low	AC 2.81	68	2.4	83	High	5	5.8	-4	1.06
				NC 2.80
				CC 2.47
Tiptur	0.5	0.5	Moderate	AC 2.25	86	2.5	75	Low	-4	12.6	-1	1.25
				NC 2.33
				CC 3.17
Koratagere	0.4	0.5	Low	AC 2.87	71	2.3	20	Moderate	3	1.8	-3	0.89
				NC 2.73
				CC 3.07
Madhugiri	0.5	0.5	Low	AC 2.50	83	2.4	40	High	4	1.3	-1	0.82
				NC 2.03
				CC 2.50
Pavagada	0.6	0.5	Moderate	AC 2.50	79	2.3	0	High	6	0	1	0.78
				NC 2.05
				CC 2.28
Kunigal	0.6	0.5	High	AC 2.12	83	2.2	75	Moderate	2	4.9	-4	0.96
				NC 2.59
				CC 2.83
Sira	0.7	0.9	High	AC 1.80	68	2.2	100	Moderate	6	8.3	2	0.81
				NC 2.00
				CC 2.67

¹Average of degree of classroom participation of all participants from a taluka, based on assessment of attendance and classroom activity (assessed by observation notes) expressed on a scale of 0 to 1.

²Average of degree of mentoring received based on attendance of participants at mentoring sessions (0 to 1.0).

³Qualitative assessment of the taluka’s ability to retain interest of the mentor expressed as high, moderate, and low.

⁴Three dimensions of organisational commitment: Affective commitment (AC), normative commitment (NC), and continuance commitment (CC). Individual commitment measures for each of these three dimensions were computed and the averages of these were calculated by taluka. Commitment scores are on a scale of 0 to 5.

⁵Self-efficacy scores expressed on a scale of 0 to 100.

⁶Style of supervision largely assessing supportive nature of supervision (1 to 5; 1 being most supportive and 5 being most authoritative).

⁷Percentage of ever-trained members in the taluka, who expressed intention to make changes based on the capacity building programme.

⁸Stability of team assessed based on turnover of health managers in the taluka team from 2009 to 2013 expressed as high, moderate, and low. High indicates stable teams (low turnover).

⁹The net change in percentage budget utilization from 2009 to 2012. Budget utilisation for each of the PHCs in the taluka was obtained.

¹⁰The net change in proportion of caesarean sections (CS) among total deliveries from 2009 to 2012. CS at taluka hospitals is at present very low and efforts are on to improve emergency obstetric care at taluka hospitals through ensuring facilities to perform CS.

¹¹The net change in stillbirth rate (of the total live births in the taluka) from 2009 to 2012. Negative change indicates a fall in stillbirth rate.

¹²The socio-economic development index for the taluka. Scores less than 1 are considered very poor and such talukas have been designated “backward” [51].

The tools for measuring organizational commitment, self-efficacy, and supportive supervision notes on their validity in Indian settings are discussed elsewhere [39].