Common PBF Quality Indicators (N=54) by Service Typea
Common Indicators by Service Delivery Category | No. of Checklists (% of Total Checklists)b |
---|---|
Facility Equipment & Infrastructure | |
Presence of latrines/toilets which are sufficient and well maintained (clean, good condition, etc.) | 36 (53%) |
Existence of well-kept fencing around health facility buildings | 30 (44%) |
A communication system (radio or telephone) is effective 24/7 between health facility and next referral center(s) | 21 (31%) |
Existence of the health map of the geographical area is available (and displayed) | 20 (29%) |
Plan detailing the maintenance activities to be performed | 8 (12%) |
Available general inventory of all furniture and equipment | 8 (12%) |
Availability of electricity 24/7 (electricity, generator or solar power) | 8 (12%) |
Facility Management | |
Performance or activity reports submitted on time | 32 (47%) |
Financial and accounting documents (including for RBF) available and well kept (bank statements, receipts, invoices etc.) | 31 (46%) |
Waste is treated and disposed properly in accordance with regulations of health care waste management (e.g., waste pit, placental pit, incinerator) | 27 (40%) |
Meeting minutes or documentation available from management or governing committee meeting | 24 (35%) |
HMIS data analysis report for the quarter being assessed concerning priority problems | 24 (35%) |
Business plan exists and is up-to-date | 20 (29%) |
Maternal Care | |
All deliveries are carried out by qualified personnel | 27 (40%) |
Presence of proper maternity equipment (sterile clamp, maternity beds, insecticide-treated bed net) | 26 (38%) |
Sufficient water with antiseptic soap and liquid antiseptic in delivery room [verbatim] | 24 (35%) |
Weighing scale available and calibrated at zero (weight for ANC alone) | 23 (34%) |
Delivery room is in good condition: (1) Walls are made of solid material, are not cracked, and are plastered and painted; (2) Cement floor is not cracked; (3) Ceiling is in good condition; (4) Windows have glass and curtains; (5) Doors are in working condition; [Variable] Light 24/7, clean | 22 (32%) |
Book of the ANC (for mom) available – at least 10 [verbatim] | 21 (31%) |
Privacy (door or curtain) | 22 (32%) |
Newborn & Child Care | |
Vaccination (proper administration and registry) | 27 (40%) |
Baby weighing and height scale available and in working condition | 26 (38%) |
Under-5 services (EPI, growth monitoring, curative care, health promotion) are available every day (at least 5 days a week) | 22 (32%) |
IMCI care protocol is applied correctly | 21 (30%) |
Adequate supplies for child care (1% Tetracycline eye ointment; Vitamin K) | 18 (26%) |
Infectious Disease (e.g. HIV, Tuberculosis, Malaria) | |
Malaria medication in stock (Co-artemeter, Sulfadoxine/pyrimethamine, Co-trimoxazol, Quinine) | 15 (22%) |
Tuberculosis treatment in stock (Rifampicin, Streptomycin, Ethambutol) | 14 (21%) |
Correct case management of simple (uncomplicated) malaria | 14 (21%) |
ARI protocol correctly applied for children <5 years | 13 (19%) |
Well-equipped HIV counseling room ensuring privacy | 13 (19%) |
Correct case management of severe (complicated) malaria | 12 (18%) |
Knowledge of tuberculosis danger signs and criteria for referral | 12 (18%) |
Laboratory | |
Available and functional microscope | 23 (34%) |
Availability of parasites demonstrations (GE/FS, stools, sputum) (on laminated paper, in a color book, or posters) | 20 (29%) |
Lab results are correctly recorded in the lab register and conform with the results in the patient booklet or lab request slip | 20 (29%) |
Availability of a working centrifuge | 18 (26%) |
Waste disposal performed correctly—organic waste in a bin with lid, safety box for sharp objects available and destroyed according to waste disposal directives | 18 (26%) |
Non-Communicable Diseases (NCDs) | |
Hypertension managed according to protocol | 4 (6%) |
Hypertension diagnosis correctly made | 2 (3%) |
Counseling materials (IEC) are available for hypertension | 2 (3%) |
Diabetes diagnosed correctly | 2 (3%) |
Diabetes protocol applied | 2 (3%) |
Proper screening for hypertension conducted | 2 (3%) |
Inpatient & Outpatient | |
Consultation room offers physical privacy | 24 (35%) |
Presence of a triage system with numbered cards or tokens to follow a cue | 23 (34%) |
Lighting available in every room (outpatient consultation and inpatient) | 21 (31%) |
Materials exams available in the consultation room and functional (e.g., thermometer, stethoscope, otoscope, sterile gloves, weight, tongue depressor) | 21 (31%) |
Examination bed available | 21 (31%) |
Community Engagement* | |
List and mapping of community health workers | 3 (4%) |
Pharmacy | |
Drugs stored properly | 25 (37%) |
Stock of essential drugs (paracetamol, diazepam, glucose solution, oxytocin, etc.) | 18 (26%) |
Pharmacy compliant with: (1) Shelves, (2) ventilated, (3) protection against direct sunlight, (4) protection against theft | 17 (25%) |
Stock record cards are kept accurately | 17 (25%) |
No expired drugs or falsified labels | 15 (22%) |
Abbreviations: ANC, antenatal care; ARI, acute respiratory infection; EPI, Expanded Programme on Immunization; FS, Frottis Sanguin (for blood smear) GE, Goutte Epaisse (for blood smear); HMIS, health management information system; IEC, information, education, and communication; IMCI, Integrated Management of Childhood Illness; PBF, performance-based financing; RBF, results-based financing.
↵a Five most “common” (frequency of indicator across entire sample of checklists) indicators are listed for each service category. In the event of a tie, we included all indicators that shared the same frequency, with the exception of community engagement (see footnote c).
↵b Analysis based on 68 checklists (total sample).
↵c Only 1 common indicator (of 68) for community engagement was observed across 3 checklists. In 2 of the checklists, there were 15+ community engagement indicators. Due to the low “commonality” of these indicators and the inability to distinguish the 5 most common indicators, we have included only the top (most frequent) indicator for community engagement.