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Table 1 Overview quality of care study component

From: Design of an impact evaluation using a mixed methods model – an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi

Study component

Data collection activity (Data source)

Tool used

Key outcome measures

Quality of Care : Structural & Input elements

Assessment of facility infrastructure (health facility, heads of services)

Structured observation survey

• Adequacy of infrastructural and organizational set-up in relation to EmOC standards

  

• Availability, accessibility, functionality of materials and equipment in obstetric care, ANC, PNC services

  

• Availability, accessibility of clinical guidelines and protocols related to obstetric care, ANC, PNC

  

• Availability, accessibility of essential drugs related to obstetric care, ANC, PNC

Assessment of providers’ professional qualification & technical knowledge (maternity care providers)

Structured interview survey (using clinical vignettes)

• Number & type of provider training activities

• Level of providers’ technical knowledge on EmOC, ANC, PNC

Quality of Care : Process & Outcome elements

Assessment of provider-patient encounters (obstetric care visits, ANC visits)

Structured observation survey

• Clinical case management (clinical assessment, diagnosis, treatment) of obstetric, pregnant, and newborn patients

Assessment of health facility records (maternity registers, patient charts)

Structured observation survey

• Timely identification of obstetric/neonatal complication (patient assessment, diagnostic procedures)

  

• Timely supportive and definitive management of obstetric/neonatal complications (intravenous fluids, oxygen, antibiotics, blood transfusion, C-sections)

  

• Case outcomes (length of stay, fatality, disability)

Quality of Care : Experiential elements

Assessment of providers’ workload, motivation, satisfaction (maternity care providers)

Structured interview survey

• Provider’s role, responsibility, workload

• Provider’s training background and appreciation

• Provider’s compensation and incentives

• Provider’s satisfaction and motivation

Assessment of clients’ perception, satisfaction, experience (women attending obstetric care, ANC, or PNC services)

Structured exit interview survey

• Clients’ demographic and socioeconomic information

• Type of care received at healthcare facility

• Type of care received at outside formal health sector

 

• Clients’ perception of healthcare services received

  

• Clients’ knowledge retention related to danger signs

  

• Clients’ satisfaction of healthcare services received

  1. EmOC = Emergency Obstetric Care, ANC = Antenatal Care, PNC = Postnatal Care, QUAN = quantitative, qual = qualitative.