Verification Process and Means of Assessing Quality of Care in PBF Programs
| Country (Year)Facility Level | No. of Indicators per Checklista | Verification Process | Means of Assessmentb | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Frequency | Verifier | Checklists No. (%) | Patient Record Review No. (%) | Register Review No. (%) | Direct Observation No. (%) | Staff Survey No. (%) | Patient Survey No. (%) | Exit Interview No. (%) | ||
| Afghanistan (2012) | ||||||||||
| Secondary & Tertiary | 15 | Quarterly | Regional govt. team | 0 (0) | 1 (7) | 6 (40) | 0 (0) | 0 (0) | 8 (53) | 0 (0) |
| Armenia (2014) | ||||||||||
| Primary & Secondary | 28 | Biannually | Regional govt. team | 0 (0) | 22 (79) | 6 (21) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Benin (2014) | ||||||||||
| Primary | 215 | Quarterly | Regional govt. team | 172 (80) | 19 (9) | 22 (10) | 0 (0) | 2 (1) | 0 (0) | 0 (0) |
| Tertiary | 240 | Quarterly | Peer-to-peer | 201 (84) | 22 (9) | 15 (6) | 1 (<1) | 1 (<1) | 0 (0) | 0 (0) |
| Burkina Faso (2011) | ||||||||||
| Primary | 143 | Quarterly | NA | 64 (45) | 50 (35) | 29 (20) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Tertiary | 119 | 46 (39) | 53 (45) | 20 (17) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Burundi (2010) | ||||||||||
| Primary | 188 | Quarterly | Regional govt. team & NGO (patient surveys) | 153 (81) | 27 (14) | 8 (5) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Tertiary | 63 | Quarterly | Peer-to-peer & NGO (patient surveys) | 44 (70) | 13 (21) | 5 (8) | 0 (0) | 1 (1) | 0 (0) | 0 (0) |
| Cameroon (2012) | ||||||||||
| Primary | 165 | Quarterly | Regional govt. team | 141 (85) | 14 (8) | 10 (6) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Tertiary | 139 | Peer-to-peer | 112 (81) | 4 (3) | 22 (16) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Congo (2014) | ||||||||||
| Primary | 185 | NA | NA | 148 (80) | 6 (4) | 23 (16) | 7 (5) | 1 (0) | 0 (0) | 0 (0) |
| Tertiary | 237 | 185 (78) | 18 (10) | 25 (14) | 7 (4) | 2 (0) | 0 (0) | 0 (0) | ||
| Democratic Republic of the Congo (2015) | ||||||||||
| Primary | 167 | Quarterly | Regional govt. team | 146 (87) | 10 (6) | 9 (5) | 1 (0) | 1 (0) | 0 (0) | 0 (0) |
| Tertiary | 237 | Quarterly | Regional govt. team & Peer-to-peer | 187 (79) | 25 (11) | 17 (7) | 7 (3) | 1 (0) | 0 (0) | 0 (0) |
| Democratic Republic of the Congo (2012) | ||||||||||
| Primary | 143 | Quarterly | Regional govt. team & PROSANI team | 130 (91) | 5 (4) | 6 (4) | 1 (<1) | 1 (<1) | 0 (0) | 0 (0) |
| Tertiary | 158 | 137 (87) | 4 (2) | 17 (11) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Djibouti (2014) | ||||||||||
| Primary | 193 | Quarterly | Regional govt. team | 166 (86) | 16 (8) | 11 (6) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Tertiary | 163 | Peer-to-peer | 141 (87) | 12 (7) | 9 (6) | 0 (0) | 1 (0) | 0 (0) | 0 (0) | |
| Gambia, The (2015) | ||||||||||
| Primary | 240 | NA | NA | 195 (81) | 6 (3) | 33 (14) | 0 (0) | 1 (<1) | 5 (2) | 0 (0) |
| Tertiary | 275 | 221 (80) | 8 (3) | 40 (15) | 0 (0) | 1 (<1) | 5 (2) | 0 (0) | ||
| Haiti (2013) | ||||||||||
| Primary | 147 | Quarterly | NGO | 131 (89) | 4 (3) | 11 (8) | 0 (0) | 1 (<1) | 0 (0) | 0 (0) |
| Ivory Coast (2014) | ||||||||||
| Primary & Secondary | 155 | Quarterly | Regional govt. team | 132 (85) | 6 (4) | 16 (10) | 0 (0) | 1 (<1) | 0 (0) | 0 (0) |
| Kenya (2015) | ||||||||||
| Primary & Tertiary | 85 | Quarterly | Regional govt. team | 78 (92) | 1 (1) | 6 (7) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Kyrgyz Republic (2012) | ||||||||||
| Tertiary | 49 | Quarterly | Peer-to-peer | 39 (80) | 7 (14) | 0 (0) | 1 (2) | 1 (2) | 1 (2) | 0 (0) |
| Laos (2014) | ||||||||||
| Tertiary | 176 | NA | NA | 147 (84) | 25 (14) | 4 (2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Lesotho (2014) | ||||||||||
| Primary | 135 | Quarterly | Regional govt. team | 102 (76) | 10 (7) | 19 (14) | 2 (1) | 1 (<1) | 1 (<1) | 0 (0) |
| Tertiary | 221 | 161 (73) | 19 (9) | 40 (18) | 1 (<1) | 0 (0) | 0 (0) | 0 (0) | ||
| Liberia (2013) | ||||||||||
| Tertiary | 141 | NA | NA | 132 (94) | 1 (<1) | 8 (6) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Malawi (2015) (KfW) | ||||||||||
| Primary, Secondary | 76 | Quarterly | Regional govt. team | 59 (78) | 12 (16) | 5 (7) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Malawi (2015) (USAID) | ||||||||||
| Primary | 193 | Biannually | Regional govt. team | 151 (78) | 16 (8) | 5 (3) | 20 (10) | 1 (<1) | 0 (0) | 0 (0) |
| Mozambique (2012) | ||||||||||
| Primary & Tertiary | 179 | Biannually | Regional govt. team & managing NGO | 97 (54) | 0 (0) | 4 (2) | 78 (44) | 0 (0) | 0 (0) | 0 (0) |
| Primary & Tertiary | 81 | 48 (59) | 29 (36) | 0 (0) | 3 (4) | 0 (0) | 0 (0) | 0 (0) | ||
| Primary & Tertiary | 26 | 15 (58) | 7 (27) | 4 (15) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Nigeria (2013) | ||||||||||
| Primary | 182 | Quarterly | Regional govt. team | 164 (90) | 3 (2) | 7 (4) | 8 (4) | 0 (0) | 0 (0) | 0 (0) |
| Tertiary | 228 | Peer-to-peer | 189 (83) | 21 (9) | 10 (4) | 7 (3) | 1 (1) | 0 (0) | 0 (0) | |
| Rwanda (2012) | ||||||||||
| Primary | 206 | Quarterly | Regional govt. team & Facility management | 139 (67) | 10 (5) | 27 (13) | 30 (15) | 0 (0) | 0 (0) | 0 (0) |
| Rwanda (2009) (CHW) | ||||||||||
| Primary | 111 | Quarterly | NA | 76 (68) | 28 (25) | 3 (3) | 4 (4) | 0 (0) | 0 (0) | 0 (0) |
| Senegal (2015) | ||||||||||
| Primary | 72 | Quarterly | National & regional govt. team | 61 (85) | 3 (4) | 7 (10) | 1 (1) | 0 (0) | 0 (0) | 0 (0) |
| Tertiary | 109 | 91 (83) | 6 (6) | 12 (11) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Sierra Leone (2012) | ||||||||||
| Primary | 61 | Quarterly | 61 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Tertiary | 17 | Peer-to-peer | 10 (59) | 1 (6) | 6 (35) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Tajikistan (2014) | ||||||||||
| Primary | 60 | Quarterly | Regional govt. team | 50 (83) | 6 (10) | 4 (7) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| Primary (Rural HC) | 93 | 72 (77) | 17 (18) | 4 (4) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Tanzania (2015) (World Bank) | ||||||||||
| Primary | 64 | Quarterly | Regional govt. team | 41 (64) | 6 (9) | 10 (16) | 0 (0) | 0 (0) | 7 (11) | 0 (0) |
| Secondary | 109 | 83 (76) | 14 (13) | 6 (6) | 0 (0) | 0 (0) | 6 (6) | 0 (0) | ||
| Tanzania (2015) (Danida) | ||||||||||
| Primary | 32 | NA | NA | 24 (75) | 0 (0) | 9 (28) | 1 (3) | 1 (3) | 1 (3) | 0 (0) |
| Secondary, Tertiary | 44 | 35 (80) | 4 (9) | 5 (11) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Uganda (2013) | ||||||||||
| Primary | 26 | NA | NA | 8 (31) | 0 (0) | 8 (31) | 5 (19) | 0 (0) | 0 (0) | 5 (19) |
| Vietnam (2014) | ||||||||||
| Primary | 71 | NA | NA | 48 (68) | 10 (14) | 7 (10) | 0 (0) | 5 (7) | 1 (1) | 0 (0) |
| Secondary | 57 | 27 (47) | 16 (28) | 10 (18) | 1 (2) | 2 (3) | 1 (2) | 0 (0) | ||
| Zambia (2012) | ||||||||||
| Primary | 76 | Quarterly | Regional govt. team | 61 (80) | 3 (4) | 2 (3) | 10 (13) | 0 (0) | 0 (0) | 0 (0) |
| Avg. No. of Indicators: 125 | ||||||||||
| Total No. of Indicators Collected: 8,490 | ||||||||||
| Avg. per Assessment Method | 6,656 (78) | 731 (9) | 771 (9) | 248 (3) | 34 (<1) | 45 (<1) | 5 (<1) | |||
Abbreviations: CHW, community health worker; GF, Global Fund to Fight AIDS, Tuberculosis and Malaria; govt., government; HC, health center; KfW, Kreditanstalt Für Wiederaufbau; MoPH, Ministry of Public Health; PROSANI, XXX; USAID, U.S. Agency for International Development.
Note: Quarterly equates to a 3-month period of time.
↵a Only the most recent quality checklist per program were included in this analysis, amounting to a total of 50 checklists.
↵b Definitions for Means of Assessment: checklist, a verifier physically observes and assigns a point value; direct observation of a clinical consultation by the verifier; facility register, into which detailed patient contacts with the health facility are entered; patient record, in which consultation and treatment information is recorded by providers; patient survey, assessing the quality of care through a survey of patients; staff interview obtains information and knowledge from staff; exit interview, formal meeting with patient that is leaving the facility.