facility attendance) Service Organization DS Little local-level adaptation to services Some local-level adaptation of services Significant local-level adaptation of (e.g., no/few modifications to facility services hours; no development of mandated programs) CAP No mechanisms in place to ensure Some mechanisms in place to ensure Mechanisms in place to ensure quality quality of services (e.g., patient quality of services but not consistently of services and consistently used complaint procedures; inter-sectoral used collaboration) ACC Locally elected officials not involved Locally elected officials somewhat Locally elected officials very involved and/or involvement not acted upon involved and/or involvement sometimes and/or involvement usually acted upon (e.g., no action taken regarding service acted upon complaints) Monitoring and Evaluation DS Local officials have no ability to Some local adaptation of centrally set Significant local-level adaptation of influence monitorable performance monitorable parameters monitorable parameters parameters, which are set at the centre CAP No/little local-level use of monitoring Some use of monitoring Regular use of monitoring mechanisms (e.g., HMIS, budget mechanisms/performance feedback from mechanisms/performance feedback from execution, HRM); no/little performance above above feedback from above ACC Locally elected officials are not Locally elected officials are Locally elected officials are empowered involved/given any feedback about involved/given feedback about to monitor and demand feedback/action performance of health programs and performance of health programs and related to performance of health facilities in their area facilities but without formal authorities programs and facilities
facility attendance) Service Organization DS Little local-level adaptation to services (e.g., no/few modifications to facility hours; no development of programs) Some local-level adaptation of services Significant local-level adaptation of services CAP No mechanisms in place to ensure quality of services (e.g., patient complaint procedures; inter-sectoral collaboration) Some mechanisms in place to ensure quality of services but not consistently used Mechanisms in place to ensure quality of services and consistently used ACC Locally elected officials not involved and/or involvement not acted upon (e.g., no action taken regarding service complaints) Locally elected officials somewhat involved and/or involvement sometimes acted upon Locally elected officials very involved and/or involvement usually acted upon Monitoring and Evaluation DS Local officials have no ability to influence monitorable performance parameters, which are set at the centre Some local adaptation of centrally set monitorable parameters Significant local-level adaptation of monitorable parameters CAP No/little local-level use of monitoring mechanisms (e.g., HMIS, budget execution, HRM); no/little performance feedback from above Some use of monitoring mechanisms/performance feedback from above Regular use of monitoring mechanisms/performance feedback from above ACC Locally elected officials are not involved/given any feedback about performance of health programs and facilities in their area Locally elected officials are involved/given feedback about performance of health programs and facilities but without formal authorities Locally elected officials are empowered to monitor and demand feedback/action related to performance of health programs and facilities mandated
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