Table 2 Attributes of care: structure, process and outcome

FP commodities available (score from 0–11)

Combined pill, Progestin only pill, Emergency Contraceptives, Injectables, IUCD, implants, male and female condoms, male and female sterilization, fertility based methods.

Testing reagents available (0–12)

Reagents for HIV (Elisa HIV-1 and Elisa HIV-2) Rapid reagents for HIV testing, Reagents for anaemia test, TB, urinary tract infections, malaria, cervical cancer screening and pregnancy test

General supplies (0–6)

Disposable needles and syringes, Insecticide treated nets, specimen bottles/pots for urine, sputum and blood, slides for malaria parasites

Essential vaccines (0–6)

Tetanus Toxoid, BCG, Measles, Polio, Hepatitis B, Pentavalent

ARV Drugs (0–7)

Nevirapine tabs and syrup, Zidovudine (ZDV, AZT),AZT syrup, Stavudine, Zidovudine + Lamivudine (Combivir),Miconazole or clotrimazole pessaries,

STI and RH drugs (0–10)

Ciprofloxacin oral, Erythromycin oral, Tetracycline oral, Benzathine Penicillin, Cotrimoxazole tabs and syrup, Metronidazole tablets, Metronidazole IV, Gentamicin IV, Amoxycillin

Infection control supplies (0–9)

Sterile and clean latex gloves, clean non-latex gloves, decontamination solution, waste receptacle with and without lid and plastic liner, container for used sharps, single use hand drying towels or a functioning electric hand dryer, running water

FP equipment/supplies (0–18)

speculum (small/medium/ large), tenacula, troca, surgical scissors, kidney dishes, sponge holding forceps, mosquito forceps – curvedand straight, surgical blade: size 15/11, draping towels, betadine, gauze, elastoplast

Delivery supplies/kits (0–5)

Delivery kit, Suture kit, Minilap BTL kit, Foetal scope, MVA kit

General equipment (0–7)

A working blood pressure machine, stethoscope, spotlight or flashlight orexamination light, examination couch, functional weighing scales for babiesand adults, autoclave/ sterilizer

Emergency equipment (0–5)

Oxygen, Adult and newborn resuscitation set Magnesium Sulphate, Calcium gluconate.

General infrastructure/utilities (0–11)

Waiting area is shaded and with seats, Waiting area for new admissions, Heater for delivery room and nursery, Functioning delivery bed, Postnatal ward, Private space for FP, ANC and PNC examination, 24 h supply of clean water and power to ensure fridge remains functional, Reliable lighting, Client toilets, Clean water for drinking with clean cups/glasses.

Updates in last 24 months (0–7)

Family planning, contraceptive technology updates, targeted postnatal care, PMTCT, screening for cervical cancer, EONC.

Knowledge of postnatal care (0–5)

Routine health care for mother and baby, return to fertility, family planning counselling, infant feeding, immunizations

Knowledge of maternal danger signs (0–7)

Foul smelling vaginal discharge, heavy vaginal bleeding, severe lower abdominal pain, fever with or without chills, swollen hands, face, legs, severe headache and/or blurred vision. excessive tiredness or breathlessness,

Knowledge of basic preventive newborn care(0–7)

Early initiation of and exclusive breastfeeding for 6 months, early detection of problems/anger signs, clean delivery practices, warmth, cord, eye care.

Knowledge of danger signs in newborn (0–6)

Poor or no breastfeeding /feeding, difficulty breathing, hypothermia or hyperthermia, septic spots/boils on body, restlessness or irritability, jaundice.

History taking (0–7)

Date of delivery, if resumed menses, about HIV status, about medication currently taken, place of delivery, mode of delivery, if currently breast feeding.

Physical examination (0–7)

Took client’s temperature and blood pressure, check for pallor (anaemia), examine breasts and nipples, palpate the client’s abdomen for uterine involution, checked perineum and discharge/lochia, checked extent of PV bleeding.

Danger signs advice given (0–3)

Excessive vaginal bleeding, fever with or without chills, broken scars(Perineum/Caesarean).

Fertility advice given (0–5)

Discuss return to fertility, discuss healthy timing and spacing of pregnancies, discuss the health benefits for mother and baby when birth spacing, resume sexual activity and discussion of any method.

STI/HIV risk assessment (0–3)

STI with the client, HIV/AIDS with the client, STI and/or HIV risk factors with the client.

STI/HIV risk factors (0–4)

Multiple partners, STIs increase risk of HIV, unprotected sexual intercourse, not knowing partner’s status.

STI management (0–3)

Give information on symptoms of an STI, screen for STI, advise to seek medical treatment if they notice STI symptoms.

Infant feeding advice (0–3)

Discussed infant feeding, discuss how mother was managing with breastfeeding, re-emphasize exclusive feeding (either breast or replacement).

Infant examination (0–4)

Examine baby (undressed), check temperature, check baby’s respirations, baby weighing.

Infant danger signs discussed (0–4)

Feeding difficulties - not sucking or sucking poorly, breathing difficulties, body feels hot or too cold, jaundice.

Documentation (0–4)

Provider looked at client’s health card before beginning the consultation/ while collecting information/examining the client, has a post-partum register, recorded information in register/tally sheet wrote on the client’s card.

Rapport (0–7)

Greets client, used clients name, introduces herself, tells client what will be done, Encourages client to ask question, ensured privacy, assures confidentiality, courteous to client throughout.

Family planning uptake within 0–10 weeks

Proportion of clients receiving preferred methods.

Infant immunisation

Proportion of newborns received BCG

Waiting time (average)

Wait before seeing provider.

Time spent with provider

Length of consultation.

Baby or mother seen by provider

Within 48 h, between 3–7 days, between 1–2 weeks’ between 3–6 weeks, more than 6 weeks.

Satisfaction

Satisfied, somewhat satisfied or not satisfied at all with services received.