Evaluating the use of locally-based health facility assessments in Afghanistan: a pilot study of a novel research method

Table 4 Comparison of health service evaluation indicator scores generated from locally-based assessments at secure and insecure facilities

Indicator label	Secure facilities [mean(SD)]	Insecure facilities [mean(SD)]	P-value¹
Based on patient-provider observation:
Patient history and physical exam	0.71 (.29)	0.88 (0.17)	<0.001
Based on patient exit interview:
Patient satisfaction	0.76 (0.30)	0.81 (0.26)	0.26
Patient perceptions of quality	0.67 (0.22)	0.74 (0.15)	0.005
Based on health worker interview:
Salary payment current	0.27 (0.45)	0.26 (0.45)	0.85
Provider knowledge: vaccination	0.83 (0.27)	0.68 (0.36)	0.07
Provider knowledge: integrated management of childhood illness	0.51 (0.22)	0.40 (0.14)	0.12
Provider knowledge: reproductive health	0.56 (0.22)	0.67 (0.078)	0.30
Based on facility record audit:
Drug availability	0.93 (0.18)	0.88 (0.25)	0.65
Family planning availability	0.84 (0.17)	0.83 (0.24)	0.92
Health management information systems use	0.70 (0.31)	0.64 (0.39)	0.67
Clinical guidelines	0.73 (0.23)	0.56 (0.28)	0.17
General infrastructure	0.70 (0.26)	0.64 (0.27)	0.79
Proper sharps disposal	0.82 (0.41)	0.85 (0.38)	0.75
Outpatient service utilization	0.88 (0.35)	0.63 (0.52)	0.28
Facilities providing antenatal care	0.73 (0.47)	0.54 (0.52)	0.40
Delivery care according to national guidelines	0.82 (0.41)	0.39 (0.51)	0.03
Females as proportion of new outpatients	0.58 (0.078)	0.56 (0.13)	0.65
Service utilization	3018 (1960)	1494 (1024)	0.04
Tuberculosis register	0.55 (0.52)	0.53 (0.52)	0.71

Mean scores represent the average score for that indicator among all facilities of a given security status (11 secure facilities versus 13 insecure facilities). Only facilities that were surveyed by the locally-based approach are included above. Scores ranged from 0 (poor) to 1 (excellent). Among variables used to calculate the indicator scores, 46 of 4312 (1.7%) and 81 of 4312 (1.9%) observations were missing for the secure and insecure facilities, respectively.
SD = Standard Deviation.
¹p-value calculated using multiple linear regression to compare indicator scores by security level, controlling for facility type (SHC, BHC, CHC); p-values <0.05 are in bold.

ISSN: 1752-1505