Table 4.

Adjustments to vignettes, direct observations and client satisfaction surveys

Method	Adjustments	Countries
Vignette	Focus vignettes on top ten burden of disease	Cambodia; DRC; ROC; (Kyrgyzstan planned)
	Quantified and weighted
	Use of trained district and provincial health supervisors
	Third-party counter verification
Direct observation	Modify to competency tests	Cambodia; Kyrgyzstan; (DRC and ROC planned)
	Quantified and weighted
	Focus on major maternal and neonatal emergencies (post-partum hemorrhage and neonatal resuscitation)
	At hospital level inclusion of the “WHO Surgical Safety Checklist” as a competency test (in Cambodia and Kyrgyzstan)
	Use of trained district and provincial health supervisors
	Third-party counter verification
Patient satisfaction survey	Quantified and weighted	Kyrgyzstan; Cambodia; DRC and ROC
	Likert scales
	Smart content of care tracers
	Use of trained district and provincial health supervisors
	Third-party counter verification

DRC – Democratic Republic of the Congo, ROC – Republic of the Congo, WHO – World Health Organization