Service quality in contracted facilities.
Community Health Sciences; Women and Child Health
The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework.
Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities.
Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006).
The study shows that contracting out initiatives have the potential to improve MNH care.
This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.
International Journal of Health Care Quality Assurance
Pradhan, N. A.,
Azam, S. I.,
(2015). Service quality in contracted facilities.. International Journal of Health Care Quality Assurance, 28(5), 520-531.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/197