Table 2.

Measures categorized as per WHO aspects of health systems performance assessment

WHO aspects Measures	Overall Level of Health	Distribution of Health in Population	Overall Level of Responsiveness	Distribution of Responsiveness	Distribution of Resources	Distribution of Financial Contribution
Global standard: Measures from WHO aspects of performance assessment [15]	1. Mortality rate: age and specific 2. Morbidity rate: age and disease specific 3. Maternal Mortality Ratio 4. Infant Mortality rate and Neonatal Mortality rate 5. DALE/DALY/HALE 6. Life expectancy 7. Disease and disability prevalence	1. Immunization coverage 2. Antenatal care 3. Natal care: percentage of deliveries attended by trained personnel 4. Growth monitoring 5. Contraceptive prevalence rate 6. Emergence of communicable disease	1. Quality of care 2. Client satisfaction	1. Availability and use of facilities 2. Human resources for health	1. Human resources 2. Healthcare facilities	1. Government health budget 2. Contribution of NGOs/donors on health services 3. Contribution for insurance 4. Individual out-of-pocket expenditure 5. Measurement of health system efficiency: Per capita expenditure 6. Education/ average years of schooling
Measures from review of articles	• Case detection and Treatment Success Rate [42] • Incidence, prevalence and mortality by disease [42] • Community health [31] • Number of deliveries and maternal mortality figs. [33]	• Coverage of general / program specific services [37, 39, 42] • Community health [31]	• Client experience and satisfaction with quality of care: privacy, doctor client interaction, nurse client interaction, staff attitude, explanation, economic feasibility, availability of drugs, cost of service/drugs [32, 34, 36, 42] • waiting time, time with provider, cleanliness, environment [32, 36] • Facility hours, privacy, patient records, health education [34] • Provider and key informant satisfaction with budget, costs, financial resources, facility and local management characteristics and linkages [34] • Number of patients served [30, 34] • Provider client bonding [42, 44] • Program implementation [39] • Services / skill item performance: quality, quantity, efficiency, problem solving capacity, adaptability [30] • Primary health care experiences with respect to: access, gate keeping/ first contact, comprehensiveness, coordination, family focus [40, 41] • Community orientation, Provider characteristics [36, 40] • Attributes of primary care- Longitudinality, comprehensiveness, coordination [40, 41]	• Use of antenatal, childbirth, immunization services, environmentally induced disease like malaria, pneumonia, diarrhoea [31, 32, 39] • Utilization of maternal and child health services like abortion, under 5 year mortality, preventive & curative services, antenatal care, delivery services, family planning services [32] • Availability and coverage of care [37, 40] • Attributes of primary care- first contact, community orientation, provider characteristics [41]	Human resources: • Skill sets: prenatal, intra natal and post-natal care protocol [35, 38] • Active participation in core activities [30, 38] Attitude and characteristics of provider- punctuality, response time, absenteeism, supervisory practices, collaboration, co-ordination, community orientation, compliance to health needs, health activities performed [33, 36, 37, 39, 40, 41]and collaboration Facility provision: Availability of supplies, maintained registers, cleanliness [33, 34, 36, 37] Accessibility [34, 40, 41, 43] • Organization accessibility (building size to patient load) • Economic accessibility • Geographic accessibility Basic Infrastructure: building structure, toilet, clean running water, electricity, communication, equipment and instrument, furniture, drugs and supplies [34]	• Funding received /expenditure [34, 42] • Cost effectiveness [34]