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Levels and variations in the quality of facility-based antenatal care in Kenya: evidence from the 2010 service provision assessment

机译：肯尼亚基于设施的产前护理质量的水平和差异：2010年服务提供评估的证据

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摘要

Quality of care is emerging as an important concern for low- and middle-income countries working to expand and improve coverage. However, there is limited systematic, large-scale empirical guidance to inform policy design. Our study operationalized indicators for six dimensions of quality of care that are captured in currently available, standardized Service Provision Assessments. We implemented these measures to assess the levels and heterogeneity of antenatal care in Kenya. Using our indicator mix, we find that performance is low overall and that there is substantial variation across provinces, management authority and facility type. Overall, facilities performed highest in the dimensions of efficiency and acceptability/patient-centeredness, and lowest on effectiveness and accessibility. Public facilities generally performed worse or similarly to private or faith-based facilities. We illustrate how these data and methods can provide readily-available, low-cost decision support for policy.
机译：护理质量正在成为中低收入国家努力扩大和改善覆盖范围的重要问题。但是，仅有有限的系统，大规模的经验指导来指导政策设计。我们的研究对当前可用的标准化服务提供评估中涵盖的六个质量护理维度的指标进行了操作。我们实施了这些措施，以评估肯尼亚产前护理的水平和异质性。使用我们的指标组合，我们发现整体绩效低下，各省，管理机构和设施类型之间存在很大差异。总体而言，设施在效率和可接受性/以患者为中心的维度上表现最高，而在有效性和可及性方面则表现最低。公共设施的表现通常较私人或基于信仰的设施差或类似。我们将说明这些数据和方法如何为政策提供随时可用的低成本决策支持。

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