Percentage of WHO Quality Statements assessable by each quality assessment tool
| Percentage of Quality Measures assessable in each Quality Statement | |||||||||
| WHO-Europe | WHO-SE Asia | SPA | HRBF | HeRAMS | r-HFA | SARA | HFS-IMCI | HCAHPS-Child | |
| Standard 1: Every child receives evidence-based care and management of illness according to WHO guidelines | |||||||||
| Statement 1.1 All children are triaged and promptly assessed for emergency and priority signs to determine whether they require resuscitation and receive appropriate care according to WHO guidelines. (n=19) | 63% | 58% | 68% | 16% | 63% | 26% | 16% | 16% | 0% |
| Statement 1.2 All sick infants, especially small newborns, are thoroughly assessed for serious bacterial infection and receive appropriate care according to WHO guidelines (n=19) | 37% | 79% | 42% | 11% | 11% | 16% | 16% | 11% | 0% |
| Statement 1.3 All children with cough or difficult breathing are correctly assessed, classified and investigated and receive appropriate care and/or antibiotics for pneumonia, according to WHO guidelines. (n=18) | 83% | 83% | 61% | 17% | 61% | 39% | 28% | 33% | 0% |
| Statement 1.4 All children with diarrhoea are correctly assessed and classified and receive appropriate rehydration and care, including continued feeding, according to WHO guidelines. (n=19) | 74% | 68% | 68% | 32% | 74% | 53% | 16% | 42% | 0% |
| Statement 1.5 All children with fever are correctly assessed, classified and investigated and receive appropriate care according to WHO guidelines. (n=19) | 58% | 68% | 58% | 37% | 47% | 42% | 32% | 26% | 0% |
| Statement 1.6 All infants and young children are assessed for growth, breastfeeding and nutrition, and their carers receive appropriate support and counselling, according to WHO guidelines. (n=12) | 83% | 75% | 50% | 33% | 17% | 25% | 17% | 25% | 0% |
| Statement 1.7 All children at risk for acute malnutrition and anaemia are correctly assessed and classified and receive appropriate care according to WHO guidelines. (n=16) | 75% | 88% | 44% | 38% | 56% | 25% | 31% | 25% | 0% |
| Statement 1.8 All children at risk for TB and/or HIV infection are correctly assessed and investigated and receive appropriate management according to WHO guidelines. (n=17) | 47% | 29% | 47% | 65% | 41% | 18% | 41% | 0% | 0% |
| Statement 1.9 All children are assessed and checked for immunisation status and receive appropriate vaccinations according to the guidelines of the WHO expanded programme on immunisation. (n=12) | 17% | 58% | 100% | 75% | 42% | 50% | 58% | 58% | 0% |
| Statement 1.10: All children with chronic conditions receive appropriate care, and they and their families are sufficiently informed about their condition(s) and are supported to optimise their health, development and quality of life. (n=12) | 42% | 0% | 33% | 8% | 17% | 0% | 25% | 0% | 0% |
| Statement 1.11 All children are screened for evidence of maltreatment, including neglect and violence, and receive appropriate care. (n=7) | 29% | 0% | 0% | 0% | 29% | 0% | 0% | 0% | 0% |
| Statement 1.12: All children with surgical conditions are screened for surgical emergencies and injuries and receive appropriate surgical care. (n=12) | 33% | 17% | 17% | 8% | 25% | 8% | 17% | 0% | 0% |
| Statement 1.13: All sick children, especially those who are most seriously ill, are adequately monitored, reassessed periodically and receive supportive care according to WHO guidelines. (n=14) | 93% | 50% | 36% | 0% | 21% | 7% | 7% | 0% | 0% |
| Statement 1.14: All children receive care with standard precautions to prevent health care-associated infections. (n=14) | 64% | 50% | 50% | 57% | 43% | 21% | 36% | 7% | 0% |
| Statement 1.15: All children are protected from unnecessary or harmful practices during their care. (n=12) | 67% | 33% | 17% | 0% | 0% | 0% | 0% | 8% | 0% |
| Standard 2: The health information system ensures the collection, analysis and use of data to ensure early, appropriate action to improve the care of every child | |||||||||
| Statement 2.1: Every child has a complete, accurate, standardised, up-to-date medical record, which is accessible throughout their care, on discharge and on follow-up. (n=13) | 62% | 38% | 23% | 15% | 0% | 23% | 0% | 8% | 0% |
| Statement 2.2: Every health facility has a functional mechanism for data collection, analysis and use as part of its activities for monitoring performance and quality improvement. (n=9) | 44% | 67% | 78% | 56% | 0% | 44% | 0% | 0% | 0% |
| Statement 2.3: Every health facility has a mechanism for collecting, analysing and providing feedback on the services provided and the perception of children and their families of the care received. (n=7) | 43% | 57% | 57% | 57% | 0% | 0% | 0% | 29% | 43% |
| Standard 3: Every child with condition(s) that cannot be treated effectively with the available resources receives appropriate, timely referral, with seamless continuity of care | |||||||||
| Statement 3.1: Every child who requires referral receives appropriate prereferral care, and the decision to refer is made without delay. (n=10) | 30% | 30% | 30% | 50% | 40% | 0% | 0% | 20% | 0% |
| Statement 3.2: Every child who requires referral receives seamless, coordinated care and referral according to a plan that ensures timeliness. (n=12) | 33% | 0% | 17% | 42% | 17% | 8% | 8% | 25% | 0% |
| Statement 3.3: For every child referred or counter-referred within or among health facilities, there is appropriate information exchange and feedback to relevant healthcare staff. (n=6) | 67% | 33% | 83% | 17% | 100% | 17% | 17% | 0% | 0% |
| Standard 4: Communication with children and their families is effective, with meaningful participation and responds to their needs and preferences | |||||||||
| Statement 4.1 All children and their carers are given information about the child’s illness and care effectively, so that they understand and cope with the condition and the necessary treatment. (n=13) | 85% | 23% | 38% | 31% | 0% | 15% | 0% | 23% | 69% |
| Statement 4.2 All children and their carers experience coordinated care, with clear, accurate information exchange among relevant health and social care professionals and other staff. (n=9) | 22% | 11% | 11% | 11% | 0% | 0% | 0% | 0% | 0% |
| Statement 4.3 All children and their carers are enabled to participate actively in the child’s care, in decision making, in exercising the right to informed consent and in making choices, in accordance with their evolving capacity. (n=10) | 80% | 10% | 10% | 20% | 0% | 0% | 0% | 0% | 20% |
| Statement 4.4 All children and their carers receive appropriate counselling and health education, according to their capacity, about the current illness and promotion of the child’s health and well-being. (n=13) | 23% | 38% | 46% | 31% | 31% | 8% | 0% | 31% | 8% |
| Standard 5: Every child’s rights are respected, protected and fulfilled at all times during care, without discrimination | |||||||||
| Statement 5.1 All children have the right to access healthcare and services, with no discrimination of any kind. (n=9) | 78% | 11% | 44% | 22% | 11% | 0% | 0% | 11% | 0% |
| Statement 5.2 All children and their carers are made aware of and given information about children’s rights to health and healthcare. (n=9) | 44% | 0% | 0% | 0% | 0% | 0% | 0% | 0% | 0% |
| Statement 5.3 All children and their carers are treated with respect and dignity, and their right to privacy and confidentiality is respected. (n=7) | 57% | 14% | 43% | 43% | 0% | 14% | 14% | 0% | 57% |
| Statement 5.4 All children are protected from any violation of their human rights, physical or mental violence, injury, abuse, neglect or any other form of maltreatment. (n=9) | 11% | 0% | 0% | 0% | 22% | 0% | 0% | 0% | 0% |
| Statement 5.5 All children have access to safe, adequate nutrition that is appropriate for both their age and their health condition during their care in a facility. (n=10) | 40% | 30% | 20% | 10% | 0% | 10% | 10% | 0% | 0% |
| Standard 6: All children and their families are provided with educational, emotional and psychosocial support that is sensitive to their needs and strengthens their capability | |||||||||
| Statement 6.1 All children are allowed to be with their carers, and the role of carers is recognised and supported at all times during care, including rooming-in during the child’s hospitalisation. (n=9) | 78% | 22% | 0% | 0% | 0% | 0% | 0% | 0% | 11% |
| Statement 6.2 All children and their families are given emotional support that is sensitive to their needs, with opportunities for play and learning that stimulate and strengthen their capability. (n=10) | 60% | 10% | 0% | 0% | 0% | 0% | 0% | 0% | 20% |
| Statement 6.3 Every child is assessed routinely for pain or symptoms of distress and receives appropriate management according to WHO guidelines. (n=13) | 62% | 0% | 8% | 0% | 0% | 0% | 0% | 0% | 23% |
| Standard 7: For every child, competent, motivated, empathic staff are consistently available to provide routine care and management of common childhood illnesses | |||||||||
| Statement 7.1 All children and their families have access at all times to sufficient health professionals and support staff for routine care and management of childhood illnesses. (n=15) | 67% | 27% | 40% | 53% | 0% | 13% | 0% | 13% | 7% |
| Statement 7.2 Health professionals and support staff have the appropriate skills to fulfil the health, psychological, developmental, communication and cultural needs of children. (n=17) | 76% | 47% | 65% | 71% | 6% | 35% | 18% | 24% | 6% |
| Statement 7.3 Every health facility has managerial leadership that collectively develops, implements and monitors appropriate policies and legal entitlements that foster an environment for continuous quality improvement. (n=12) | 67% | 25% | 50% | 50% | 0% | 17% | 0% | 8% | 8% |
| Standard 8: The health facility has an appropriate, child friendly physical environment, with adequate water, sanitation, waste management, energy supply, medicines, medical supplies and equipment for routine care and management of common childhood illnesses. | |||||||||
| Statement 8.1 Children are cared for in a well-maintained, safe, secure physical environment with an adequate energy supply and which is appropriately designed, furnished and decorated to meet their needs, preferences and developmental age. (n=15) | 40% | 47% | 40% | 33% | 20% | 13% | 33% | 0% | 20% |
| Statement 8.2 Child-friendly water, sanitation, hand hygiene and waste disposal facilities are easily accessible, functional, reliable, safe and sufficient to meet the needs of children, their carers and staff. (n=22) | 68% | 59% | 41% | 45% | 41% | 18% | 18% | 0% | 0% |
| Statement 8.3 Child-friendly, age-appropriate equipment designed to meet children’s needs in medical care, learning, recreation and play are available at all times. (n=15) | 40% | 27% | 27% | 27% | 33% | 7% | 33% | 0% | 13% |
| Statement 8.4 Adequate stocks of child-friendly medicines and medical supplies are available for the routine care and management of acute and chronic childhood illnesses and conditions. (n=14) | 71% | 64% | 57% | 50% | 43% | 43% | 50% | 14% | 0% |
Red boxes indicate that the assessment tool did not assess any; orange boxes indicate less than half; yellow boxes indicate equal to or more than half and green boxes indicate all of the quality measures were assessable in the associated quality statement.
HCAHPS, Hospital Consumer Assessment of Healthcare Providers and Systems; HeRAMS, Health Resources Availability Mapping System; HFS-IMCI, Health Facility Survey—using Integrated Management of Childhood Illness clinical guidelines; HRBF, Health Results Based Financing impact evaluation toolkit; n, number of Quality Measures within the associated Quality Statement; r-HFA, rapid Health Facility Assessment; SARA, Service Availability and Readiness Assessment; SPA, Service Provision Assessment.;