Stability of healthcare quality measures for maternal and child services: Analysis of the continuous service provision assessment of health facilities in Senegal, 2012-2018.

Autor: Leslie HH; Division of Prevention Science, Department of Medicine, University of California, San Francisco, California, USA.; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA., Hategeka C; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA., Ndour PI; Directorate of Planning, Research, and Statistics, Ministry of Health and Social Action, Dakar, Senegal.; Agence Nationale de la Démographie et de la Statistique, Dakar, Senegal., Nimako K; Health Systems Consultant, Accra, Ghana., Dieng M; Directorate of Planning, Research, and Statistics, Ministry of Health and Social Action, Dakar, Senegal., Diallo A; Directorate of Planning, Research, and Statistics, Ministry of Health and Social Action, Dakar, Senegal., Ndiaye Y; Directorate of Planning, Research, and Statistics, Ministry of Health and Social Action, Dakar, Senegal.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2022 Jan; Vol. 27 (1), pp. 68-80. Date of Electronic Publication: 2021 Dec 16.
DOI: 10.1111/tmi.13701
Abstrakt: Objective: High-quality healthcare is essential to ensuring maternal and newborn survival. Efficient measurement requires knowing how long measures of quality provide consistent insight for intended uses.
Methods: We used a repeated health facility assessment in Senegal to calculate structural and process quality of antenatal care (ANC), delivery and child health services in facilities assessed 2 years apart. We tested agreement of quality measures within facilities and regions. We estimated how much input-adjusted and process quality-adjusted coverage measures changed for each service when calculated using quality measurements from the same facilities measured 2 years apart.
Results: Over 6 waves of continuous surveys, 628 paired assessments were completed. Changes at the facility level were substantial and often positive, but inconsistent. Structural quality measures were moderately correlated (0.40-0.69) within facilities over time, more so in hospitals; correlation was <0.20 for process measures based on direct observation of ANC and child visits. Most measures were more strongly correlated once averaged to regions; process quality of child services was not (-0.32). Median relative difference in national-adjusted coverage estimates was 6.0%; differences in subnational estimates were largest for process quality of child services (19.6%).
Conclusion: Continuous measures of structural quality demonstrated consistency at regional levels and in higher level facilities over 2 years; results for process measures were mixed. Direct observation of child visits provided inconsistent measures over time. For other measures, linking population data with health facility assessments from up to 2 years prior is likely to introduce modest measurement error in adjusted coverage estimates.
(© 2021 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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