ArticleBMJ global health2021
Measuring facility readiness to provide childbirth care: a comparison of indices using data from a health facility survey in Ethiopia.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Hidden cities, hidden gaps: measuring facility readiness for maternal and newborn health services and its association with person-centred maternity care in sub-Saharan Africa's urban informal settlements.Journal of global health · 2026Article
- Specific service readiness for sick child health services and its relationship with quality of care and user experience in eight low-and middle-income countries.BMC health services research · 2026Article
- Advancing maternal and newborn healthcare measurement: developing quality of care indices for postnatal and small and/or sick newborn care in low- and middle-income countries.Journal of global health · 2025Article
- Building an effective coverage cascade for antenatal care: linking of household survey and health facility assessment data in eight low- and middle-income countries.Journal of global health · 2025Article
- Factors affecting antenatal corticosteroid use in low- and middle-income countries: Facility characteristics, structural readiness, and past performance of CEmONC signal functions.PLOS global public health · 2025Article
- Article
- Beyond facility-based births: Is Uganda delivering effective maternal and newborn care? An analysis of the 2022 demographic health survey and 2023 harmonized health facility assessment survey.PLOS global public health · 2025Article
- Association between antenatal care facility readiness and provision of care at the client level and facility level in five low- and middle-income countries.BMC health services research · 2023Article
- Service availability and readiness to provide comprehensive emergency obstetric and newborn care services in post-conflict at North Wollo Zone hospitals, Northeast Ethiopia: mixed survey.BMC health services research · 2023Article
- Understanding variation in person-centered maternity care: Results from a household survey of postpartum women in 6 regions of Ethiopia.AJOG global reports · 2023Article
- Assessment of health system readiness for routine maternal and newborn health services in Nepal: Analysis of a nationally representative health facility survey, 2015.PLOS global public health · 2022Article
- Article
- Factors influencing place of delivery in Ethiopia: Linking individual, household, and health facility-level data.PLOS global public health · 2022Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundActionable information about the readiness of health facilities is needed to inform quality improvement efforts in maternity care, but there is no consensus on the best approach to measure readiness. Many countries use the WHO's Service Availability and Readiness Assessment (SARA) or the Demographic and Health Survey (DHS) Programme's Service Provision Assessment to measure facility readiness. This study compares measures of childbirth service readiness based on SARA and DHS guidance to an index based on WHO's quality of maternal and newborn care standards.
methodsWe used cross-sectional data from Performance Monitoring for Action Ethiopia's 2019 survey of 406 health facilities providing childbirth services. We calculated childbirth service readiness scores using items based on SARA, DHS and WHO standards. For each, we used three aggregation methods for generating indices: simple addition, domain-weighted addition and principal components analysis. We compared central tendency, spread and item variation between the readiness indices; concordance between health facility scores and rankings; and correlations between readiness scores and delivery volume.
resultsIndices showed moderate agreement with one another, and all had a small but significant positive correlation with monthly delivery volume. Ties were more frequent for indices with fewer items. More than two-thirds of items in the relatively shorter SARA and DHS indices were widely (>90%) available in hospitals, and half of the SARA items were widely (>90%) available in health centres/clinics. Items based on the WHO standards showed greater variation and captured unique aspects of readiness (eg, quality improvement processes, actionable information systems) not included in either the SARA or DHS indices.
conclusionSARA and DHS indices rely on a small set of widely available items to assess facility readiness to provide childbirth care. Expanded selection of items based on the WHO standards can better differentiate between levels of service readiness.
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