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Face and content validity of a prospective multidimensional performance instrument for service delivery in district
Elias Ali Yesuf1,2, Eva Grill3, Günter Fröschl1,4
1CIHLMU Center for International Health, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, München, Germany.
Background:
Valid performance indicators help to track and improve health services. The aim of this study was to test the face and content validity of a set of performance indicators for service delivery in district health systems of low-income countries.
Methods:
A Delphi method with three stages was used. A panel of experts voted (yes vs no) on the face value of performance indicators. Agreement on the inclusion of indicators was a score of >75% and ≥50% during stages one and two, respectively. During stage three, indicators with a mean score of ≥3.8 on a five-point scale were included. The panel also rated the content validity of the overall set of indicators.
Results:
The panel agreed on the face value of 59 out of 238 performance indicators. Agreement on the content validity of the set of indicators reached 100%. Most of the retained indicators were related to the capacity of health facilities, the quality of maternal and child health services and HIV care and treatment.
Conclusions:
Policymakers in low-income countries could use a set of performance indicators with modest face and high content validity, and mainly aspects of capacity and quality to improve health service delivery in districts.
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