Quality of Care Framework | Themes | Major determinants | Minor determinants |
---|---|---|---|
(reported in five or more studies) | (reported in fewer than five studies) | ||
Access | Convenience of access | Distance & transport connectivity | Access to drugs; opening and closing timings |
Structure | Physical environment | - | Good infrastructure, electricity, water supply, waiting area, seating arrangement, facility management (patient access and consultation systems, information channels, financial management) |
Cleanliness | Cleanliness, clean toilets, hygiene maintenance | Housekeeping services | |
Human resources | - | Staffing adequacy, availability of doctors to manage emergencies, availability of nursing personnel | |
Medicines, supplies & services | Availability of drugs and equipment | Availability of - ‘good’ services; ambulance services; lab services; blood supply & transfusion services | |
Process of care | Promptness of care | Waiting time before admission or consultation | Timely attendance, constant attention; prompt referral; immediate contact with newborn |
Interpersonal behavior | Respectful behavior by doctors, nurses and support staff | Therapeutic communication; encouragement during delivery | |
Privacy & confidentiality | Privacy & confidentiality during examinations and delivery | - | |
Perception of ‘good’ care | Length of consultation; completeness of procedures; perception of negligent care; perceived provider competence | - | |
Cognitive support | Prenatal counseling and health education | Information shared with women about their condition and care; sense of ‘participation’ in the process; culturally sensitive communication | |
Emotional support | Birth companion of choice | Social networks of expectant mothers; support from family members | |
Preference for female providers | Preference for female providers | - | |
Cost | Cost of care | Financial cost of care | Affordable drugs, availability of financial support for care |
Outcome | Delivery outcome | - | Healthy newborn; survival of maternal illness; successful labour outcome for mother & baby |
Other determinants | Maternal characteristics | - | Age, parity, whether pregnancy was intended, stress during delivery and postpartum |
Socio-cultural determinants | Literacy | Ethnicity, religion, type of locality where facility is located, expectation of baby’s gender, positive impact of first experience of care |