Common PBF Quality Indicators (N=54) by Service Typea

Common Indicators by Service Delivery CategoryNo. 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 buildings30 (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 performed8 (12%)
Available general inventory of all furniture and equipment8 (12%)
Availability of electricity 24/7 (electricity, generator or solar power)8 (12%)
Facility Management
Performance or activity reports submitted on time32 (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 meeting24 (35%)
HMIS data analysis report for the quarter being assessed concerning priority problems24 (35%)
Business plan exists and is up-to-date20 (29%)
Maternal Care
All deliveries are carried out by qualified personnel27 (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, clean22 (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 condition26 (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 correctly21 (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) malaria14 (21%)
ARI protocol correctly applied for children <5 years13 (19%)
Well-equipped HIV counseling room ensuring privacy13 (19%)
Correct case management of severe (complicated) malaria12 (18%)
Knowledge of tuberculosis danger signs and criteria for referral12 (18%)
Available and functional microscope23 (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 slip20 (29%)
Availability of a working centrifuge18 (26%)
Waste disposal performed correctly—organic waste in a bin with lid, safety box for sharp objects available and destroyed according to waste disposal directives18 (26%)
Non-Communicable Diseases (NCDs)
Hypertension managed according to protocol4 (6%)
Hypertension diagnosis correctly made2 (3%)
Counseling materials (IEC) are available for hypertension2 (3%)
Diabetes diagnosed correctly2 (3%)
Diabetes protocol applied2 (3%)
Proper screening for hypertension conducted2 (3%)
Inpatient & Outpatient
Consultation room offers physical privacy24 (35%)
Presence of a triage system with numbered cards or tokens to follow a cue23 (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 available21 (31%)
Community Engagement*
List and mapping of community health workers3 (4%)
Drugs stored properly25 (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 theft17 (25%)
Stock record cards are kept accurately17 (25%)
No expired drugs or falsified labels15 (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.