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Assessing the Utility of a Quality-of-Care Assessment Tool Used in Assessing Comprehensive Care Services Provided by Community Health Workers in South Africa

Bibliographic Data

ID22089504
AuthorsOlukemi Babalola (University of the Witwatersrand, corresponding author), Jane Goudge (0000-0001-6555-7510, University of the Witwatersrand), Jonathan Levin (0000-0002-6177-614X, University of the Witwatersrand), Celia Brown (0000-0002-7526-0793, University of Warwick), Frances Griffiths (0000-0002-4173-1438, University of Warwick)
Year2022
Volume10
Pages868252-868252
Publication date2022-05-16
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2022.868252
PMID35651863
OpenAlexW4280623722
LanguageEN
Citations received1
References cited67

Background: Few studies exist on the tools for assessing quality-of-care of community health worker (CHW) who provide comprehensive care, and for available tools, evidence on the utility is scanty. We aimed to assess the utility components of a previously-reported quality-of-care assessment tool developed for summative assessment in South Africa. Methods: In two provinces, we used ratings by 21 CHWs and three team leaders in two primary health care facilities per province regarding whether the tool covered everything that happens during their household visits and whether they were happy to be assessed using the tool (acceptability and face validity), to derive agreement index (≥85%, otherwise the tool had to be revised). A panel of six experts quantitatively validated 11 items of the tool (content validity). Content validity index (CVI), of individual items (I-CVI) or entire scale (S-CVI), should be >80% (excellent). For the inter-rater reliability (IRR), we determined agreement between paired observers' assigned quality-of-care messages and communication scores during 18 CHW household visits (nine households per site). Bland and Altman plots and multilevel model analysis, for clustered data, were used to assess IRR. Results: In all four CHW and team leader sites, agreement index was ≥85%, except for whether they were happy to be assessed using the tool, where it was <85% in one facility. The I-CVI of the 11 items in the tool ranged between 0.83 and 1.00. For the S-CVI, all six experts agreed on relevancy (universal agreement) in eight of 11 items (0.72) whereas the average of I-CVIs, was 0.95. The Bland-Altman plot limit of agreements between paired observes were -0.18 to 0.44 and -0.30 to 0.44 (messages score); and -0.22 to 0.45 and -0.28 to 0.40 (communication score). Multilevel modeling revealed an estimated reliability of 0.77 (messages score) and 0.14 (communication score). Conclusion: The quality-of-care assessment tool has a high face and content validity. IRR was substantial for quality-of-care messages but not for communication score. This suggests that the tool may only be useful in the formative assessment of CHWs. Such assessment can provide the basis for reflection and discussion on CHW performance and lead to change

Content validity · Environmental health · Face validity · Family medicine · Formative assessment · Geography · Health care · Psychometrics · Summative assessment · Clinical Psychology · Computer Science · Global Maternal and Child Health · Medicine · Nursing · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes · Psychology

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Unique citing works1
Citations per year0,33
Citation span2023 - 2023 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1
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