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Organizational Levels of Care
When developing indicators to monitor the quality of maternal care, one needs to consider various organizational levels of the health care system (operational/facility, intermediate, and strategic). The indicators will vary based on the level and on the specific standards selected for measuring quality (QAP/URC,2001c). Whenever possible, the QA team should select indicators that use available data collected through the routine health information system. A brief description of organizational levels follows.
The table below describes the differences among these levels.
LevelMonitoring ObjectiveProcessPeople InvolvedOperationalTrack service delivery processes, results, and the availability of inputs
Emphasize individual processes or services at the facility level Management and improvement teams that examine the quality of processes at the facility level Intermediate Compare processes carried out at the operational level Emphasize the results and products of the combined processes or services Heads of departments, programs, and services at the district level Strategic Evaluate the overall system results, compare results with objectives, act on differences, assure the quality of the entire system Emphasize the overall results of the system and strategy to better meet objectives Top organizational management at the national, regional, or local government levels