Table 5.
Descriptive values of items and dimensions of the COACH tool in Rwanda (N=223)
| Scaled dimensions/items | Mean | Median | Disagree | Neutral | Agree |
| Organizational resources | 3.1 | 3.0 | – | – | – |
| Human resources | 2.6 | 2.5 | – | – | – |
| This facility has enough workers with the right training and skills to do everything that needs to be done for hypertension | 2.7 | 2.0 | 121 (54%) | 43 (19%) | 59 (27%) |
| This facility has enough workers with the right training and skills to do their job in the best possible way for hypertension | 2.6 | 2.0 | 123 (55%) | 41 (18%) | 59 (27%) |
| Space | 3.0 | 3.0 | – | – | – |
| This facility has enough space to provide healthcare services for HTN | 3.0 | 3.0 | 96 (43%) | 29 (13%) | 98 (44%) |
| Communication and transport | 3.3 | 3.5 | – | – | – |
| This facility has access to the transport and fuel that are needed to provide healthcare services for hypertension | 3.3 | 4.0 | 60 (27%) | 51 (23%) | 112 (50%) |
| This facility has access to the communication tools (eg, telephones or radios) that are needed to provide healthcare services for hypertension | 3.3 | 4.0 | 65 (29%) | 37 (17%) | 121 (54%) |
| Financing | 2.9 | 3.0 | – | – | – |
| This facility receives money according to a budget for hypertension | 2.9 | 3.0 | 42 (19%) | 153 (69%) | 28 (13%) |
| This facility has money that we can decide how to use for hypertension | 2.9 | 3.0 | 52 (23%) | 140 (63%) | 31 (14%) |
| Medicines and equipment | 3.3 | 3.5 | – | – | – |
| This facility has enough medicine to provide healthcare services for hypertension | 3.1 | 3.0 | 81 (36%) | 39 (18%) | 103 (46%) |
| This facility has enough functional equipment to provide healthcare services for hypertension | 3.1 | 3.0 | 80 (35.9%) | 38 (17%) | 105 (47%) |
| This facility has enough disposable medical equipment, such as syringes, gloves and needles to provide healthcare services for hypertension | 4.0 | 4.0 | 24 (11%) | 15 (7%) | 184 (83%) |
| If the workload increases, the facility can get additional resources such as medicine and equipment for hypertension | 3.1 | 3.0 | 59 (27%) | 84 (38%) | 80 (36%) |
| Community engagement | 3.5 | 3.6 | – | – | – |
| In this facility, we ask community members what they think about the healthcare services that we provide for hypertension | 3.3 | 4.0 | 46 (21%) | 63 (28%) | 114 (51%) |
| In this facility, we listen to what community members think about the healthcare services we provide for hypertension | 3.7 | 4.0 | 30 (14%) | 41 (18%) | 152 (68%) |
| In this facility, we have meetings with community members to discuss health matters regarding hypertension | 3.6 | 4.0 | 30 (14%) | 48 (22%) | 145 (65%) |
| In this facility, we encourage community members to contribute to improving hypertension in the community | 3.7 | 4.0 | 29 (13%) | 33 (15%) | 161 (72%) |
| In this facility, we encourage other organizations to contribute to improving hypertension in the community | 3.3 | 3.0 | 44 (20%) | 81 (36%) | 98 (44%) |
| Monitoring services for action | 3.2 | 3.2 | – | – | – |
| I receive regular updates about the facility’s performance on hypertension based on information/data collected from our facility | 2.7 | 3.0 | 110 (49%) | 51 (23%) | 62 (28%) |
| This facility discusses information/data from our facility on hypertension in a regular, formal way, such as in regularly scheduled meetings | 3.2 | 3.0 | 60 (27%) | 73 (33%) | 90 (41%) |
| This facility regularly uses facility information/data to make plans for improving its healthcare services for hypertension | 3.1 | 3.0 | 41 (18%) | 108 (48%) | 74 (33%) |
| This facility regularly monitors its work by comparing it with the facility’s action plans for hypertension | 3.2 | 3.0 | 30 (14%) | 117 (53%) | 76 (34%) |
| This facility regularly compares its work with national or other guidelines for hypertension | 3.6 | 4.0 | 19 (9%) | 68 (31%) | 136 (61%) |
| Commitment to work | 4.2 | 4.3 | – | – | – |
| I am proud to work in this facility | 4.0 | 4.0 | 16 (7%) | 24 (11%) | 183 (82%) |
| I am satisfied to work in this facility | 3.9 | 4.0 | 24 (11%) | 23 (10%) | 176 (79%) |
| I feel encouraged to do my very best at work | 4.6 | 5.0 | 6 (3%) | 8 (4%) | 209 (94%) |
| Work culture | 4.1 | 4.2 | – | – | – |
| Culture of learning and change | 3.8 | 3.7 | – | – | – |
| This facility is willing to use new healthcare practices such as guidelines and recommendations for hypertension | 3.9 | 4.0 | 8 (4%) | 45 (20%) | 170 (76%) |
| This facility helps me to improve and develop my skills in hypertension | 3.1 | 3.0 | 87 (39%) | 37 (17%) | 99 (44%) |
| I am encouraged to seek new information on healthcare practices for hypertension | 4.4 | 4.0 | 7 (3%) | 13 (6%) | 203 (91%) |
| Culture of responsibility | 4.1 | 4.0 | – | – | – |
| This facility works for the good of the clients and puts their needs first in treatment of hypertension | 3.8 | 4.0 | 17 (8%) | 51 (23%) | 155 (70%) |
| Members of the facility feel personally responsible for improving healthcare services for hypertension | 4.2 | 4.0 | 3 (1%) | 34 (15%) | 186 (83%) |
| Members of the facility approach clients with hypertension with respect | 4.4 | 4.0 | 3 (1%) | 10 (5%) | 210 (94%) |
| Leadership | 4.1 | 4.0 | – | – | – |
| I trust the facility leader | 4.2 | 4.0 | 9 (4%) | 11 (5%) | 203 (91%) |
| The leader handles stressful situations calmly | 4.0 | 4.0 | 13 (6%) | 26 (12%) | 184 (83%) |
| The leader actively listens, acknowledges, and then responds to requests and concerns | 4.0 | 4.0 | 14 (6%) | 22 (10%) | 187 (84%) |
| The leader effectively resolves any conflicts that arise | 4.1 | 4.0 | 9 (4%) | 16 (7%) | 198 (89%) |
| The leader encourages the introduction of new ideas and practices | 4.2 | 4.0 | 6 (3%) | 13 (6%) | 204 (92%) |
| The leader makes things happen | 4.0 | 4.0 | 11 (5%) | 32 (14%) | 180 (81%) |
| – | – | – | |||
| Informal payment | 4.7 | 5.0 | – | – | – |
| Clients must always give informal payment to health workers to access healthcare services for hypertension | 4.9 | 5.0 | 1 (0.4%) | 3 (1%) | 219 (98%) |
| Clients are treated more quickly if they make informal payments to health workers for hypertension | 4.9 | 5.0 | 3 (1%) | 5 (2%) | 215 (96%) |
| Medicines or equipment for hypertension that should be available for free to clients have been sold in this facility | 4.6 | 5.0 | 5 (2%) | 24 (11%) | 194 (87%) |
| Health workers are sometimes absent from work earning money at other places | 4.5 | 5.0 | 5 (2%) | 34 (15%) | 184 (83%) |
| Nepotism | 4.6 | 5.0 | – | – | – |
| Health workers in this facility give healthcare services for hypertension to friends and family first | 4.7 | 5.0 | 4 (2%) | 10 (5%) | 209 (94%) |
| Health workers in this facility give jobs or other benefits to friends and family first | 4.5 | 5.0 | 10 (5%) | 28 (13%) | 185 (83%) |
| Accountability | 2.8 | 3.0 | – | – | – |
| Efforts are made to stop clients from providing informal payment to get appropriate healthcare services in hypertention | 2.8 | 3.0 | 99 (44%) | 49 (22%) | 75 (34%) |
| Efforts are made to stop health workers from asking clients for informal payment for HTN | 2.8 | 3.0 | 97 (44%) | 40 (18%) | 86 (39%) |
| Non-scaled dimension/items | Mean | Median | Not Appropriate (NA), never, rarely | Occasionally | Frequently, always |
| Sources of knowledge | 0.6 | 0.6 | – | – | – |
| Clinical practice guidelines for hypertension | 0.7 | 1.0 | 52 (23%) | 35 (16%) | 136 (61%) |
| Other printed material for work (eg, textbooks, journals) with hypertension | 0.6 | 1.0 | 58 (26%) | 45 (20%) | 120 (54%) |
| In-service training/workshops/courses for hypertension | 0.5 | 0.5 | 102 (46%) | 41 (18%) | 80 (36%) |
| The internet for hypertension | 0.6 | 0.5 | 65 (29%) | 47 (21%) | 111 (50%) |
| Electronic decision support (eg, mobile phone applications or other electronic devices to assist with care and decision-making) for hypertension | 0.5 | 0.5 | 105 (47%) | 28 (13%) | 90 (40%) |
COACH, Context Assessment for Community Health.