Table 3.

PHIT Partnership countries’ health systems strengthening measures by health systems building block^a

		Ghana	Mozambique	Rwanda	Tanzania	Zambia
Service Delivery	Indicators	• Service utilization & quality for selected programs • Emergency referrals • Cause of maternal deaths	• Service utilization for selected programs • Patient satisfaction with PHC services • Average wait/consult time for PHC services	• Service utilization for selected programs • Facility capacity • Quality of care: Appropriate diagnosis and treatment	• Service utilization for selected programs • Time use of CHWs • Quality of IMCI	• Service utilization for selected programs • Patient satisfaction with PHC services • Quality of care: readiness and quality audit
	Sources	-HMIS -Project information system -Mortality audits -Community surveys	-Facility surveys -HMIS -Community surveys	-Facility surveys -HMIS -Community surveys	-Health & Demographic Surveillance System -Facility surveys -Project information system -Community surveys	-Facility surveys -Community surveys
Information Systems	Indicators	Not measured	• Facility & district data quality	• Community & facility data quality	• % monthly CHW reports submitted	• Timely health facility and CHW reporting
	Sources		-Data quality audits	-Data quality audits	- Project information system	-Project information system
Health Workforce	Indicators	• CHW coverage (stratified by community health nurse and midwife) • # and % of CHWs trained in IMCI & supervision frequency	• Health worker per capita by cadre • Frequency of supervision visits by district	• Health worker presence • Retention • Competency, knowledge & skills	• CHW presence during supervision • CHWs selected/trained/training results/retained • Supervisors trained & working • Frequency of supervision visit to CHWs	• Health worker motivation • Health workers trained in previous 12 months
	Sources	-Community survey -Project information system	-Project information system	-Facility surveys -Project information system	-Project information system	-Facility surveys
Leadership & Governance	Indicators	• Perceptions of governance and leadership changes	• Data utilization • % of district management teams fully staffed • Turnover of district and provincial management teams	• Data utilization • Appropriate use of resources	Not measured	• Evidence-based planning • Level of corruption
	Sources	-Process evaluation	-Special study -Project information system	-Special study -Policy analysis		-Facility surveys
Medical Products, Vaccines & Technologies	Indicators	• Continuous stocks of essential commodities (tracer medicines and equipment)	• Continuous stocks of essential commodities (tracer medicines and equipment)	• Continuous stocks of essential commodities (tracer medicines and equipment)	• Continuous stocks of essential commodities (tracer medicines and equipment)	• Continuous stocks of essential commodities (tracer medicines and equipment)
	Sources	-Project information system -Community survey -Facility surveys	-Facility surveys	-Facility surveys	-CHW stock card review	-Facility surveys
Health Financing	Indicators	• Total costs in intervention area • Incremental project cost	• Total costs in intervention area • Incremental project cost	• Total costs in intervention area • Cost by source • Incremental project cost	• Total costs in intervention area • Incremental project cost	• Total costs in intervention area • Incremental project cost
	Sources	-Project information system	-Ministry of Health reports -Project information system	-Ministry of Health & local government reports -Project information system	-Project information system	-Facility surveys

^aFurther details on the following metrics are available as a web annex to the following publication(Bryce et al., [12]): Medical products, vaccines & technologies; CHW Community Health Worker, HMIS Health Management Information System, PHC Primary Health Care, IMCI Integrated Management of Childhood Illnesses