Table 3 PHIT Partnership countries’ health systems strengthening measures by health systems building blocka
From: Measuring health systems strength and its impact: experiences from the African Health Initiative
| Â | Â | Ghana | Mozambique | Rwanda | Tanzania | Zambia |
|---|---|---|---|---|---|---|
Service Delivery | Indicators | • Service utilization & quality for selected programs • Emergency referrals • Cause of maternal deaths | • Service utilization for selected programs • Patient satisfaction with PHC services • Average wait/consult time for PHC services | • Service utilization for selected programs • Facility capacity • Quality of care: Appropriate diagnosis and treatment | • Service utilization for selected programs • Time use of CHWs • Quality of IMCI | • Service utilization for selected programs • Patient satisfaction with PHC services • Quality of care: readiness and quality audit |
| Â | Sources | -HMIS -Project information system -Mortality audits -Community surveys | -Facility surveys -HMIS -Community surveys | -Facility surveys -HMIS -Community surveys | -Health & Demographic Surveillance System -Facility surveys -Project information system -Community surveys | -Facility surveys -Community surveys |
Information Systems | Indicators | Not measured | • Facility & district data quality | • Community & facility data quality | • % monthly CHW reports submitted | • Timely health facility and CHW reporting |
| Â | Sources | Â | -Data quality audits | -Data quality audits | - Project information system | -Project information system |
Health Workforce | Indicators | • CHW coverage (stratified by community health nurse and midwife) • # and % of CHWs trained in IMCI & supervision frequency | • Health worker per capita by cadre • Frequency of supervision visits by district | • Health worker presence • Retention • Competency, knowledge & skills | • CHW presence during supervision • CHWs selected/trained/training results/retained • Supervisors trained & working • Frequency of supervision visit to CHWs | • Health worker motivation • Health workers trained in previous 12 months |
| Â | Sources | -Community survey -Project information system | -Project information system | -Facility surveys -Project information system | -Project information system | -Facility surveys |
Leadership & Governance | Indicators | • Perceptions of governance and leadership changes | • Data utilization • % of district management teams fully staffed • Turnover of district and provincial management teams | • Data utilization • Appropriate use of resources | Not measured | • Evidence-based planning • Level of corruption |
| Â | Sources | -Process evaluation | -Special study -Project information system | -Special study -Policy analysis | Â | -Facility surveys |
Medical Products, Vaccines & Technologies | Indicators | • Continuous stocks of essential commodities (tracer medicines and equipment) | • Continuous stocks of essential commodities (tracer medicines and equipment) | • Continuous stocks of essential commodities (tracer medicines and equipment) | • Continuous stocks of essential commodities (tracer medicines and equipment) | • Continuous stocks of essential commodities (tracer medicines and equipment) |
| Â | Sources | -Project information system -Community survey -Facility surveys | -Facility surveys | -Facility surveys | -CHW stock card review | -Facility surveys |
Health Financing | Indicators | • Total costs in intervention area • Incremental project cost | • Total costs in intervention area • Incremental project cost | • Total costs in intervention area • Cost by source • Incremental project cost | • Total costs in intervention area • Incremental project cost | • Total costs in intervention area • Incremental project cost |
| Â | Sources | -Project information system | -Ministry of Health reports -Project information system | -Ministry of Health & local government reports -Project information system | -Project information system | -Facility surveys |