Quality of Integrated Reproductive, Maternal, Newborn, Child, and Adolescent Health and HIV Services: Assessment Toolkit
The Assessment Toolkit for Quality of Integrated Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) and HIV Services was designed by the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project to support a comprehensive health facility assessment of the quality of care for integrated RMNCAH and HIV services at facilities in low- and middle-income countries. The survey fills an urgent need to assess the quality of RMNCAH, including HIV-related services, to inform service delivery and health system improvement efforts in USAID-assisted countries.
This survey toolkit is based on the World Health Organization (WHO) framework and standards to improve Quality of Maternal and Newborn Care and updated RMNCAH clinical recommendations tailored to low- and middle-income settings as of 2018, when these instruments were finalized. The tools are aligned with global measurement frameworks, such as the WHO Every Newborn Action Plan, WHO Quality of Care Measures around childbirth, Ending Preventable Maternal Mortality, and the WHO Global Reference List of 100 Core Health Indicators, and are tailored to USAID preventing child and maternal deaths priority country context.
The 13 tools included in the toolkit were designed, field tested, and applied in Uganda and Kenya by the USAID ASSIST Project to assess the quality of integrated RMNCAH and HIV services. The tools have a modular design and can be administered fully or partially to assess the quality of care for the following clinical content areas: ANC; maternal care during labor, delivery, and immediate postpartum periods; newborn care during childbirth period; outpatient care of young infants (0-2 months) and children from 2 months-5 years; and adolescent-friendly services.
The tools featured in the RMNCAH+HIV Toolkit include:
- Tool #1: Facility-Level Key Inputs
- Tool #2: Health Provider Questionnaire
- Tool #3: Observation of Newborn Resuscitation Bag and Mask Skills
- Tool #4: Patient Interview
- Tool #5: Observation of Antenatal Care (ANC) Visit
- Tool #6: Observation of Routine Intrapartum and Immediate Postpartum Care
- Tool #7: Observation of Sick Young Infant (< 2 months) Visit
- Tool #8: Observation of Sick Child (2 months-5 years) Visit
- Tool #9: ANC Medical Documentation Review
- Tool #10: Maternal and Newborn Care Medical Documentation Review
- Tool #11: Maternal Complication Medical Documentation Review
- Tool #12: Newborn Complication Medical Documentation Review
- Tool #13: Child Outpatient Care Medical Documentation Review