Preliminary validation of the PRImary care facility Management Evaluation tool (PRIME-Tool), a national facility management survey implemented in Ghana

Uy, Jhanna; Macarayan, Erlyn K.; Ratcliffe, Hannah L.; Miller, Kate; Otupiri, Easmon; Awoonor-Williams, John Koku; Hirschhorn, Lisa R.; Lipsitz, Stuart R.; Schwarz, Dan; Bitton, Asaf

doi:10.1186/s12913-019-4768-8

Table 3 Exploratory Factor Analysis for 2016, 2017, and 2017 with new management indicators

From: Preliminary validation of the PRImary care facility Management Evaluation tool (PRIME-Tool), a national facility management survey implemented in Ghana

			EFA₁					EFA₂					EFA₃
			2016 PRIME version 2016 data, N = 142 facilities					2016 PRIME version 2017 data, N = 148 facilities					2017 PRIME version 2017 data, N = 148 facilities
			Factors					Factors					Factors
			1	2	3	4	5	1	2	3	4	5	1	2	3	4	5	6
Item #	Original domain	Eigenvalue	2.7	2.7	2.6	2.0	1.9	2.6	2.3	2.2	2.1	1.5	2.6	2.3	2.2	2.0	1.7	1.6
		% Variance accounted for	15%	15%	14%	11%	10%	16%	15%	14%	13%	9%	12%	11%	10%	9%	8%	7%
		Number of items in factor	8	6	7	3	4	5	4	5	7	4	8	6	4	5	3	4
		Item	Factor loadings					Factor loadings					Factor loadings
24	Monitoring	Extent to which data to monitor & improve service delivery is valued	0.72							0.87			0.45			0.65
31	Community	Patients’ opinions drive change or improvement	0.65								0.55	−0.38						0.73
17	HR	Has formal, supportive, and continuous supervision system	0.61				−0.40	0.57	0.36					0.68	0.32
20	Monitoring	Maintains books to track revenue and expenditure	0.58								0.69							0.64
13	Operations	Proportion of time facility head spent on managerial activities the previous day	0.57								0.43		No loadings²
16	HR	Has established criteria to evaluate staff performance	0.48		0.54			Dropped ¹					Dropped ¹
2	Target setting	Has one comprehensive annual budget for running costs	0.48		0.42	0.34		0.36			0.64		0.33				0.52
11	Operations	Facility head has received any formal management training	0.35		0.62			0.68				0.34		0.37
26	Monitoring	Reports client opinions using any available tool		0.30	0.67				0.87						0.91
15	HR	Supervisors have held individual meetings to review staff performance		0.37		0.85		Dropped ¹					Dropped ¹
21	Monitoring	Conducts quality improvement activities		0.55	0.57				0.87	0.43					0.83	0.39
22	Monitoring	Held meetings to discuss routine service statistics with staff		0.57	0.41			0.85			0.32		0.33	0.74				0.37
27	Monitoring	Regularly receives reports tracking common conditions with results shared with staff		0.83						0.67	0.39		0.84
23	Monitoring	Has mechanism to report new disease outbreaks		0.94						0.65	0.53		0.85
32	Community	Made changes based on client opinion in the last 12 months			0.75				0.66	−0.37			−0.31	0.31	0.57
34	Community	Has a community member regularly attending staff meetings				0.85	0.37	No loadings ²					No loadings ²
30	Community	Shared information on performance with the community in the past 6 months					0.70	0.74				0.40	0.31	0.64
33	Community	Has a community advisory board that meets regularly and facility follows up on board discussions					0.81					0.89	No loadings ²
14	HR	Staff are offered training to improve their skills	Dropped ¹
29	Community	Collects client opinions using any tool	Dropped ¹
4	Target setting	Has formal goals and priorities for service delivery	7 items not included in 2016 PRIME										Dropped ¹
5	Target setting	Has formal improvement targets to achieve goals															0.88
6	Target setting	Formal improvement targets shared with staff												0.64			0.50
7	Target setting	Burden of target achievement evenly distributed to staff											No loadings ²
18	HR	Perceived ability of staff to carry out assignments											−0.34			0.68
19	HR	Staff encouraged to share new ideas to management														0.79
28	Monitoring	Conducts formal case reviews for quality														0.43		0.55

HR – Human resources
¹This item was dropped by the EFA because its lack of variation caused missing coefficients in the polychoric correlation matrix.
²This item did not load on any of the included factors with a loading of absolute value 0.32 or more

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ISSN: 1472-6963

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