Table 2.
Descriptive analysis and ceiling and floor effects of PRIME-Tool survey items for 2016 and 2017
| Item # |
Items listed by original hypothesized domain | Variable type1 | 2016 N = 142 |
2017 N = 148 |
Difference in means between years | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mean2 (Scale: 0 to 1) |
% at Floor3 |
% at ceiling3 | Mean2 (Scale: 0 to 1) |
% at floor3 |
% at ceiling3 | Absolute (Scale: 0 to 1) |
Percentage points (%) | |||
| Target setting | ||||||||||
| 1 | Measures coverage of key population indicators | Y/N | 0.92 | 8.50 | 91.50 | 0.84 | 15.54 | 84.46 | −0.08 | −8.70 |
| 2 | Has one comprehensive annual budget for running costs | Y/N | 0.71 | 28.87 | 71.13 | 0.76 | 23.60 | 76.40 | + 0.05 | 7.04 |
| 3 | Reports accountability for health outcomes of a group of people | Y/N | 0.59 | 40.80 | 59.20 | 0.52 | 47.97 | 52.03 | −0.07 | −11.86 |
| 4 | Has formal goals and priorities for service delivery | Y/N | 4 items not included in 2016 | 0.95 | 4.73 | 95.27 | – | – | ||
| 5 | Has formal improvement targets to achieve service delivery goals | Y/N | 0.45 | 54.73 | 45.27 | – | – | |||
| 6 | Formal improvement targets for service delivery shared with staff | Y/N | 0.89 | 11.49 | 88.51 | – | – | |||
| 7 | Burden of target achievement evenly distributed to facility staff (SD) | Ord. | 0.78 (0.19) | 0.00 | 29.73 | – | – | |||
| Operations | ||||||||||
| 8 | Hand washing area with soap and water available (SD) | Ord. | 0.95 (0.22) | 4.90 | 93.66 | 0.96 (0.17) | 2.70 | 93.92 | + 0.01 | 1.05 |
| 9 | Health worker present or on call in the facility 24 h a day | Y/N | 0.92 | 8.45 | 91.55 | 0.89 | 10.81 | 89.19 | −0.03 | −3.26 |
| 10 | Open every day | Y/N | 0.85 | 14.79 | 85.21 | 0.90 | 10.14 | 89.86 | + 0.05 | 5.88 |
| 11 | Facility head has received any formal management training | Y/N | 0.76 | 23.94 | 76.06 | 0.85 | 14.86 | 85.14 | + 0.09 | 11.84 |
| 12 | User fees displayed (SD) | Ord. | 0.45 (0.50) | 54.93 | 18.31 | 0.24 (0.38) | 66.89 | 15.54 | −0.21 | −46.67 |
| 13 | Proportion of time facility head spent on managerial activities the previous day (SD) | Cont. | 0.43 (0.24) | 9.90 | 1.40 | 0.39 (0.26) | 12.16 | 3.38 | −0.04 | −9.30 |
| Human resources | ||||||||||
| 14 | Staff are offered training to improve their skills | Y/N | 0.99 | 1.41 | 98.59 | 0.99 | 0.68 | 99.32 | 0.00 | 0.00 |
| 15 | Supervisors have held individual meetings to review staff performance | Y/N | 0.95 | 4.93 | 95.07 | 0.95 | 4.73 | 95.27 | 0.00 | 0.00 |
| 16 | Has established criteria to evaluate staff performance | Y/N | 0.82 | 17.61 | 82.39 | 0.96 | 4.05 | 95.95 | + 0.14 | 17.07 |
| 17 | Has formal, supportive, and continuous supervision system (SD) | Ord. | 0.79 (0.29) | 4.90 | 58.45 | 0.89 (0.22) | 1.40 | 77.03 | + 0.10 | 12.66 |
| 18 | Perceived ability of staff to carry out assignments of daily work (SD) | Ord. | 2 items not included in 2016 | 0.82 (0.21) | 2.70 | 41.90 | – | – | ||
| 19 | Staff encouraged to share new ideas to management (SD) | Ord. | 0.88 (0.14) | 0.00 | 54.10 | – | – | |||
| Monitoring | ||||||||||
| 20 | Maintains books to track revenue and expenditure (SD) | Ord. | 0.97 (0.17) | 2.80 | 54.23 | 0.82 (0.26) | 2.03 | 66.90 | −0.15 | −15.46 |
| 21 | Conducts quality improvement activities | Y/N | 0.94 | 6.34 | 93.66 | 0.95 | 4.73 | 95.27 | + 0.01 | 1.06 |
| 22 | Held meetings to discuss routine service statistics with staff | Y/N | 0.94 | 5.63 | 94.37 | 0.95 | 5.41 | 94.59 | + 0.01 | 1.06 |
| 23 | Has mechanism to report new disease outbreaks | Y/N | 0.93 | 7.04 | 92.96 | 0.97 | 2.70 | 97.30 | + 0.04 | 4.30 |
| 24 | Extent to which data to monitor & improve service delivery is valued (SD) | Ord. | 0.88 (0.19) | 2.10 | 61.97 | 0.89 (0.14) | 0.00 | 59.46 | + 0.01 | 1.14 |
| 25 | Tracks common conditions | Y/N | 0.88 | 11.97 | 88.03 | 0.91 | 8.78 | 91.22 | + 0.03 | 3.41 |
| 26 | Reports client opinions using any available tool | Y/N | 0.54 | 45.77 | 54.23 | 0.54 | 46.00 | 54.00 | 0.00 | 0.00 |
| 27 | Regularly receives reports tracking common conditions with results shared with staff (SD) | Ord. | 0.41 (0.21) | 7.70 | 2.11 | 0.40 (0.16) | 2.70 | 1.40 | −0.01 | −2.44 |
| 28 | Conducts formal case reviews for quality (SD) | Ord. | Item not included in 2016 | 0.64 (0.35) | 18.24 | 26.40 | – | – | ||
| Community engagement | ||||||||||
| 29 | Collects client opinions using any tool | Y/N | 0.95 | 4.93 | 95.07 | 0.98 | 2.03 | 97.97 | + 0.03 | 3.16 |
| 30 | Shared information on performance with the community in the past 12 months | Y/N | 0.78 | 21.83 | 78.17 | 0.84 | 16.22 | 83.78 | + 0.08 | 10.26 |
| 31 | Patients’ opinions drive change or improvement (SD) | Ord. | 0.67 (0.20) | 0.70 | 14.79 | 0.66 (0.20) | 0.68 | 12.80 | −0.01 | −1.49 |
| 32 | Made changes based on client opinion in the last 12 months | Y/N | 0.64 | 35.92 | 64.08 | 0.57 | 43.24 | 56.76 | −0.07 | −10.94 |
| 33 | Has a community advisory board that meets regularly, and facility follows up on board discussions (SD) | Ord. | 0.52 (0.49) | 45.07 | 49.30 | 0.65 (0.46) | 31.76 | 61.49 | + 0.13 | 25.00 |
| 34 | Has a community member regularly attending staff meetings | Y/N | 0.31 | 69.01 | 30.99 | 0.34 | 66.20 | 33.80 | + 0.03 | 9.68 |
1 Y/N - Binary yes/no variable; Ord. Ordinal variable; Cont. Continuous variable
2 For yes/no variables, the mean is the proportion of facilities that answered yes.
3 Numbers in bold indicate potential ceiling or floor effects (above 80% for yes/no variables and above 15% for ordinal and continuous variables)