Appendix Table 1: PCA loadings for Hospitals/Health Centers Principal Component , sorted by medical role in primary
health care and size of coefficient
Variable
Basic Clinical
Facility has all valid Nevirapine syrup
Facility pharmacy has all valid Stavudine 40
Facility has all valid Lamivudine/Stavudine 30/Nevirapine Combo
Facility has all valid Stavudine 30
Facility has all valid Lamivudine 3TC
Facility has all valid Efavirenz 600
Facility has all valid Lamivudine/Stavudine 40/Nevirapine Combo
Facility has all valid Nevirapine
Facility has all valid Lamivudine 3TC Syrup
Facility has all valid Zidovudine syrup
Number of days per month routine Vitamin A supplementation provided at facility
Cotton wool or gauze pad observed (for IUD or implant)
Sterile gloves observed (for IUD or implant)
Register/stock cards for contraceptives observed
Facility routinely weighs newborns
Antiseptic solution observed (for IUD or implant)
Sterile syringes and needles observed
Infant scale for newborn care functioning
Facility has all valid Zidovudine
Blood pressure apparatus for ANC/PNC observed
Blank partographs observed
Facility has all valid Chloramphenicol Oral
Trained counselors for pre and post testing for HIV present on day of interview
Facility has at least one valid Flagyl
Stethoscope observed
Facility has all valid Efavirenz 200
Facility has at least one valid Cotrimoxazole
Facility has all valid ORS
Days per month growth monitoring is provided at facility
Suction bulb for mucus extraction functioning
Facility has all valid Quinine Oral
Thermometer
Infant scale for PNC functioning
Antibiotic eye drops or ointment chloramphenicol
Facility has all valid Coartem
Days per week STI services are available
Advanced Clinical
C Sections ever performed at facility
Injectable oxytocin/syntocin available
Blood transfusion performed for maternity care within past 3 months
Bag and masks for infant resuscitation available
Injectable magnesium sulfate available
Bag or tube and mask (infant size) for resuscitation functional
Facility provides 24 hour coverage for delivery services
Table or bed for delivery available
Average number of Assistant Medical Officers at facility full time over past 3 months
Average number of Clinical Officers (other than CO Anesthetists) at facility full time over past 3 months
Parenteral anti-convulsants for pregnancy-induced hypertension administered at facility within past 3 months
Injectable ergometrine/ methergine available in delivery area
Average number of Public Health Nurses at facility full time over past 3 months
Average number of Midwives at facility full time over past 3 months
Parenteral oxytocin drugs administered at facility within past 3 months
0.133
0.133
0.133
0.132
0.131
0.128
0.127
0.127
0.120
0.117
0.112
0.111
0.110
0.104
0.102
0.102
0.101
0.099
0.095
0.094
0.093
0.082
0.082
0.080
0.076
0.074
0.070
0.067
0.063
0.061
0.059
0.039
0.038
0.035
0.008
-0.008
0.137
0.121
0.119
0.108
0.108
0.107
0.106
0.105
0.105
0.104
0.104
0.103
0.103
0.101
0.101
Variable
Total number of c-sections in last 12 months
Intravenous solutions (Ringers lactate, D5NS, or NS) available in delivery service area
Blood test for anemia is routine part of ANC
Facility has lab with functioning incubator for culturing
Blood bank at facility
Ventouse (vacuum extractor) available
Urine test for protein is routine part of ANC
Manual vacuum aspiration or D & C used to remove products of conception in past 3 months
Assisted delivery conducted in this facility in past 3 months
Manual removal of placenta provided in the last 3 months
Glass slides and covers available in lab
Injectable diazepam available in delivery service area
Facility has at least one valid Methyldopa
Average number of Medical Attendants/Auxiliary Nurses at facility full time over past 3 months
Acceptable light source for pelvic exam available
Facility has rapid diagnostic tests for malaria available
Private car or bus most common transport used by women coming from home to facility for obstetric emergency
Injectable amoxicillin or ampicillin available in delivery area
Facility has all valid Chloramphenical injections
Urine test for glucose is routine for ANC
Average number of Registered Nurses/Nursing Officers at facility full time over past 3 months
Facility routinely suctions the newborn by means of catheter
Average number of Clinical Officer Anesthetists at facility full time over past 3 months
Average number of Pediatricians at facility full time over past 3 months
Average number of OBGYNs at facility full time over past 3 months
Number of days per week routinely open for outpatient curative services
Average number of Anesthetists at facility full time over past 3 months
Facility has laboratory with Giemsa glass slide malaria test
Injectable gentamycin available in delivery service area
Average number of Medical Officers at facility full time over past 3 months
Average number of Other specialists at facility full time over past 3 months
Average number of Surgeons at facility full time over past 3 months
Number of days per month sick child consultation provided at facility
<=60 minutes to nearest emergency obstetric care referral facility during the dry season
Clinical Family Planning
Intrauterine device provided here
Male or female sterilization services are provided here
Impants are provided here
Intrauterine devices (IUD) are all valid
Implants are all valid
Preventive
Number of days per month BCG vaccine provided at facility
Facility stores vaccines
Oral Polio vaccines all valid
Tetanus toxoid vaccines all valid
Number days per week ANC services available
BCG and dilutant all valid
DPT+HepB vaccine all valid
Register of vaccines observed
Vitamin A All Valid
Number of days per month DPT-HB and Polio vaccine provided at facility
Measles and diluatnt All Valid
Number of days per month Measles vaccine provided at facility
Number of days per month DPT-HB and Polio vaccine provided during outreach
Number of days per month Vitamin A supplementation provided during outreach
0.099
0.098
0.098
0.095
0.095
0.094
0.090
0.090
0.088
0.085
0.083
0.080
0.079
0.076
0.076
0.076
0.074
0.067
0.066
0.066
0.064
0.061
0.059
0.058
0.053
0.047
0.046
0.046
0.038
0.038
0.037
0.035
0.017
0.008
0.123
0.114
0.106
0.096
0.085
0.118
0.116
0.116
0.112
0.110
0.106
0.104
0.104
0.103
0.102
0.094
0.070
0.044
0.043
Variable
Number of days per month BCG vaccine provided during outreach
Number of days per month Measles vaccine provided during outreach
Number of staff received training on IMCI guidelines
Basic Family Planning
Combined pill provided here
Progestin-only injectable (2 or 3 monthly) provided here
Progestin pill provided here
Combined oral pill all valid
Days/week family planning services are provided at facility
Progestin-only pill all valid
Progestin-only injection (2 or 3 monthly) all valid
Male condom provided here
Male condoms all valid
Administrative
Facility has a functional generator and fuel on day of interview
HMIS reports on HIV deaths are observed and submitted to district
Facility has a functional ambulance that can be used for any emergency
Facility has a facility-wide review of mortality
HMIS reports on HIV deaths are observed and submitted to region
Facility has a functional ambulance with fuel
Record of management meetings observed
Management meetings occur at least once every 6 months
HMIS reports on HIV deaths are observed and submitted to national level
Evidence of quality assurance committee or staff reports is observed
HMIS reports on HIV deaths are observed and submitted to donor
Supervisor observed services within the past 6 months
Facility has a working phone or radio at all times patients are served
Facility radios or phones another facility to request transportation in obstetric emergencies
Ambulance is most common transport used by women coming from home to facility for obstetric emergency
Facility has routine meetings to review management and administrative issues
TBAs refer women to facility
Incubator functioning for newborn care
Most commonly used water source at time of interview is a protected water source
Supervisor checked registers within the past 6 months
Facility hires local vehicle to provide emergency transport
% Interviews where HMIS Guidelines Seen or Reported
Meetings with staff and community occur at least once every 6 months
Routine meetings include facility staff and community
Nearby phone available at all times
0.043
0.042
0.032
0.100
0.099
0.098
0.093
0.092
0.090
0.082
0.082
0.071
0.068
0.066
0.065
0.061
0.055
0.054
0.054
0.053
0.049
0.041
0.040
0.034
0.034
0.033
0.030
0.030
0.030
0.030
0.029
0.014
0.013
0.009
0.004
0.002
-0.018
Appendix Table 2: PCA loadings for Hospitals/Health Centers Component 2, sorted by medical role in primary health
care and size of coefficient
Variable
Basic Clinical
Facility has all valid Efavirenz 200
Facility has all valid Coartem
Facility has all valid Efavirenz 600
Facility has all valid Lamivudine 3TC
Facility has at least one valid Cotrimoxazole
Facility has all valid Lamivudine/Stavudine 40/Nevirapine Combo
Facility pharmacy has all valid Stavudine 40
Facility has all valid Zidovudine syrup
Facility has all valid Zidovudine
Facility has all valid Lamivudine/Stavudine 30/Nevirapine Combo
0.125
0.106
0.102
0.102
0.100
0.098
0.098
0.097
0.095
0.094
Variable
Facility has all valid Nevirapine
Facility has all valid Lamivudine 3TC Syrup
Facility has all valid Stavudine 30
Facility has at least one valid Flagyl
Facility has all valid Nevirapine syrup
Facility has all valid Quinine Oral
Facility has all valid Chloramphenicol Oral
Trained counselors for pre and post testing for HIV present on day of interview
Facility has all valid ORS
Suction bulb for mucus extraction functioning
Antiseptic solution observed (for IUD or implant)
Blank partographs observed
Cotton wool or gauze pad observed (for IUD or implant)
Sterile gloves observed (for IUD or implant)
Thermometer
Sterile syringes and needles observed
Antibiotic eye drops or ointment chloramphenicol
Number of days per month routine Vitamin A supplementation provided at facility
Days per week STI services are available
Infant scale for newborn care functioning
Infant scale for PNC functioning
Stethoscope observed
Blood pressure apparatus for ANC/PNC observed
Facility routinely weighs newborns
Register/stock cards for contraceptives observed
Days per month growth monitoring is provided at facility
Advanced Clinical
Average number of Registered Nurses/Nursing Officers at facility full time over past 3 months
Facility has lab with functioning incubator for culturing
Average number of Midwives at facility full time over past 3 months
Average number of Medical Attendants/Auxiliary Nurses at facility full time over past 3 months
Average number of Surgeons at facility full time over past 3 months
Glass slides and covers available in lab
Average number of OBGYNs at facility full time over past 3 months
Average number of Pediatricians at facility full time over past 3 months
Facility has rapid diagnostic tests for malaria available
Average number of Clinical Officer Anesthetists at facility full time over past 3 months
Average number of Anesthetists at facility full time over past 3 months
Number of days per week routinely open for outpatient curative services
Average number of Other specialists at facility full time over past 3 months
Average number of Medical Officers at facility full time over past 3 months
Facility has laboratory with Giemsa glass slide malaria test
Average number of Assistant Medical Officers at facility full time over past 3 months
Facility has at least one valid Methyldopa
Blood bank at facility
Assisted delivery conducted in this facility in past 3 months
Parenteral anti-convulsants for pregnancy-induced hypertension administered at facility within past 3 months
C Sections ever performed at facility
Average number of Public Health Nurses at facility full time over past 3 months
Injectable magnesium sulfate available
Parenteral oxytocin drugs administered at facility within past 3 months
Injectable amoxicillin or ampicillin available in delivery area
Total number of c-sections in last 12 months
Injectable oxytocin/syntocin available
Ventouse (vacuum extractor) available
0.094
0.091
0.087
0.087
0.086
0.081
0.078
0.077
0.047
0.017
-0.010
-0.013
-0.013
-0.016
-0.017
-0.032
-0.054
-0.057
-0.060
-0.079
-0.080
-0.103
-0.106
-0.107
-0.126
-0.132
0.154
0.145
0.143
0.139
0.132
0.131
0.127
0.122
0.121
0.118
0.117
0.116
0.111
0.099
0.096
0.093
0.086
0.080
0.065
0.053
0.048
0.047
0.047
0.044
0.042
0.039
0.036
0.033
Variable
Manual removal of placenta provided in the last 3 months
Average number of Clinical Officers (other than CO Anesthetists) at facility full time over past 3 months
Urine test for glucose is routine for ANC
Bag and masks for infant resuscitation available
Acceptable light source for pelvic exam available
Blood transfusion performed for maternity care within past 3 months
Manual vacuum aspiration or D & C used to remove products of conception in past 3 months
Bag or tube and mask (infant size) for resuscitation functional
Facility routinely suctions the newborn by means of catheter
Facility has all valid Chloramphenical injections
Injectable gentamycin available in delivery service area
Urine test for protein is routine part of ANC
Private car or bus most common transport used by women coming from home to facility for obstetric emergency
Injectable diazepam available in delivery service area
Intravenous solutions (Ringers lactate, D5NS, or NS) available in delivery service area
Blood test for anemia is routine part of ANC
Number of days per month sick child consultation provided at facility
<=60 minutes to nearest emergency obstetric care referral facility during the dry season
Injectable ergometrine/ methergine available in delivery area
Table or bed for delivery available
Facility provides 24 hour coverage for delivery services
Clinical Family Planning
Intrauterine devices (IUD) are all valid
Implants are all valid
Intrauterine device provided here
Male or female sterilization services are provided here
Impants are provided here
Preventive
Number of days per month BCG vaccine provided at facility
Number of staff received training on IMCI guidelines
Number of days per month Measles vaccine provided during outreach
Number of days per month BCG vaccine provided during outreach
Number of days per month DPT-HB and Polio vaccine provided during outreach
Number of days per month Vitamin A supplementation provided during outreach
Number of days per month Measles vaccine provided at facility
Number days per week ANC services available
Number of days per month DPT-HB and Polio vaccine provided at facility
Oral Polio vaccines all valid
BCG and dilutant all valid
Register of vaccines observed
DPT+HepB vaccine all valid
Vitamin A All Valid
Facility stores vaccines
Tetanus toxoid vaccines all valid
Measles and diluatnt All Valid
Basic Family Planning
Progestin-only pill all valid
Male condoms all valid
Progestin pill provided here
Progestin-only injection (2 or 3 monthly) all valid
Progestin-only injectable (2 or 3 monthly) provided here
Male condom provided here
Combined oral pill all valid
Combined pill provided here
Days/week family planning services are provided at facility
0.027
0.025
0.021
0.016
0.016
0.014
0.014
0.013
0.007
-0.003
-0.003
-0.009
-0.014
-0.031
-0.033
-0.039
-0.050
-0.052
-0.061
-0.105
-0.116
-0.025
-0.031
-0.031
-0.034
-0.045
0.027
0.023
-0.063
-0.064
-0.065
-0.066
-0.076
-0.113
-0.116
-0.123
-0.129
-0.130
-0.133
-0.134
-0.141
-0.145
-0.152
-0.106
-0.108
-0.118
-0.118
-0.137
-0.141
-0.144
-0.146
-0.150
Variable
Administrative
HMIS reports on HIV deaths are observed and submitted to donor
Facility hires local vehicle to provide emergency transport
Incubator functioning for newborn care
HMIS reports on HIV deaths are observed and submitted to national level
Facility has a functional generator and fuel on day of interview
Facility has a functional ambulance that can be used for any emergency
Most commonly used water source at time of interview is a protected water source
Facility has a working phone or radio at all times patients are served
Ambulance is most common transport used by women coming from home to facility for obstetric emergency
Facility has a functional ambulance with fuel
Management meetings occur at least once every 6 months
Evidence of quality assurance committee or staff reports is observed
HMIS reports on HIV deaths are observed and submitted to region
HMIS reports on HIV deaths are observed and submitted to district
Nearby phone available at all times
Facility has a facility-wide review of mortality
Record of management meetings observed
Facility has routine meetings to review management and administrative issues
Supervisor observed services within the past 6 months
% Interviews where HMIS Guidelines Seen or Reported
Facility radios or phones another facility to request transportation in obstetric emergencies
Supervisor checked registers within the past 6 months
Meetings with staff and community occur at least once every 6 months
Routine meetings include facility staff and community
TBAs refer women to facility
0.080
0.060
0.051
0.050
0.048
0.047
0.047
0.042
0.034
0.020
0.016
0.012
0.007
0.006
0.004
0.000
-0.006
-0.014
-0.037
-0.048
-0.050
-0.063
-0.075
-0.075
-0.131
Appendix Table 3: PCA loadings for Dispensaries Principal Component, sorted by medical role in primary health care
and size of coefficient
Variable
Basic Clinical
Stethoscope observed
Register/stock cards for contraceptives observed
Blood pressure apparatus for ANC/PNC observed
Facility routinely weighs newborns
Thermometer
Infant scale for postpartum care functioning
Infant scale for newborn care functioning
Blank partographs observed
Days per month growth monitoring is provided at facility
Number of days per month routine Vitamin A supplementation provided at facility
Antibiotic eye drops or ointment chloramphenicol
Register/stock cards for medicines observed
Suction bulb for mucus extraction functioning
Facility has all valid ORS
Facility has all valid Coartem
Days per week STI services are available
Facility has at least one valid Flagyl
Facility has all valid Quinine Oral
Facility has all valid Chloramphenicol Oral
Advanced Clinical
Table or bed for delivery available
Facility provides 24 hour coverage for delivery services
Injectable ergometrine/ methergine available in delivery area
0.162
0.160
0.154
0.143
0.143
0.123
0.118
0.111
0.104
0.102
0.100
0.092
0.030
0.028
-0.046
-0.050
-0.055
-0.064
-0.099
0.153
0.134
0.131
Variable
Injectable diazepam available in delivery service area
Facility has all valid Chloramphenical injections
Intravenous solutions (Ringers lactate, D5NS, or NS) available in delivery service area
<=60 minutes to nearest emergency obstetric care referral facility during the dry season
Facility routinely suctions the newborn by means of catheter
<=60 minutes to nearest emergency obstetric care referral facility during the wet season
Bag and masks for infant resuscitation available
Bag or tube and mask (infant size) for resuscitation functional
Manual removal of placenta provided in the last 3 months
Average number of Registered Nurses/Nursing Officers at facility full time over past 3 months
Average number of Public Health Nurses at facility full time over past 3 months
Average number of Clinical Officers (other than CO Anesthetists) at facility full time over past 3 months
Facility has laboratory with Giemsa glass slide malaria test
Number of days per week routinely open for outpatient curative services
Facility has at least one valid Methyldopa
Average number of Assistant Medical Officers at facility full time over past 3 months
Facility has laboratory with Field Stain glass slide malaria test
Glass slides and covers available in lab
Facility has rapid diagnostic tests for malaria available
Preventive
Facility stores vaccines
Measles and diluatnt All Valid
Vitamin A All Valid
Tetanus toxoid vaccines all valid
Register of vaccines observed
DPT+HepB vaccine all valid
Oral Polio vaccines all valid
BCG and dilutant all valid
Number days per week ANC services available
Number of days per month DPT-HB and Polio vaccine provided at facility
Number of days per month Vitamin A supplementation provided during outreach
Number of days per month DPT-HB and Polio vaccine provided during outreach
Number of days per month BCG vaccine provided at facility
Number of days per month BCG vaccine provided during outreach
Number of days per month Measles vaccine provided during outreach
Number of days per month Measles vaccine provided at facility
Basic Family Planning
Progestin-only injectable (2 or 3 monthly) provided here
Combined pill provided here
Days/week family planning services are provided at facility
Male condom provided here
Combined oral pill all valid
Progestin-only injection (2 or 3 monthly) all valid
Progestin pill provided here
Male condoms all valid
Progestin-only pill all valid
Administrative
TBAs refer women to facility
Routine meetings include facility staff and community
Meetings with staff and community occur at least once every 6 months
Record of meetings with staff and community observed
% Interviews where HMIS Guidelines seen or reported
Facility radios or phones another facility to request transportation in obstetric emergencies
Supervisory checklist of health system components observed for quality assurance
Supervisor checked registers within the past 6 months
0.120
0.069
0.066
0.057
0.045
0.037
0.035
0.035
0.030
-0.073
-0.073
-0.073
-0.076
-0.080
-0.080
-0.081
-0.122
-0.134
-0.136
0.173
0.164
0.161
0.160
0.157
0.150
0.149
0.148
0.144
0.132
0.102
0.102
0.101
0.098
0.097
0.097
0.176
0.175
0.168
0.160
0.155
0.140
0.138
0.129
0.112
0.135
0.119
0.113
0.077
0.063
0.047
0.043
0.040
Variable
% Interviews where any special HMIS training seen or reported
Management meetings occur at least once every 6 months
Supervisor observed services within the past 6 months
Periodic audit of medical records or service registers observed for quality assurance
Facility has routine meetings to review management and administrative issues
Record of management meetings observed
Facility has a working phone or radio at all times patients are served
Referral document observed
Facility hires local vehicle to provide emergency transport
Facility has a functional ambulance that can be used for any emergency
Most commonly used water source at time of interview is a protected water source
Facility has a functional generator and fuel on day of interview
0.040
0.038
0.037
0.032
0.031
0.029
-0.045
-0.050
-0.054
-0.059
-0.072
-0.079