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Table 1 Definitions of structural quality of care components

From: Approaches to improve the quality of maternal and newborn health care: an overview of the evidence

Community-level inputs
Outreach services – Home visitation/referral: standardized or individualized programs of additional social support provided in either home visits, during regular antenatal clinic visits, and/or by telephone on several occasions during pregnancy.
Health workforce - Task shifting: health care workers including nurses, midwives, technicians or other lay health workers, that are lesser trained than specialized personnel but substitute for them or perform aspects of their tasks.
Health workforce – Training: include in-service and on the job trainings, conferences, lectures, workshops, seminars, symposia, and courses. It also included additional training of outreach workers namely, lady health workers/visitors, community midwives, and community/village health workers. Clinical practice guideline implementation was also included.
Community engagement/support groups: included formation of community support groups or formation of committee comprising of community representatives for health promotion.
District-level inputs
Governance and accountability: any systematic approach to ensure that services are accountable for delivering quality healthcare including audit and feedback mechanisms, medical registries, and continuous quality improvement tools.
Leadership and supervision: provision of monitoring, guidance and feedback on matters of personal, professional and educational development in the context of the patient care
Financial strategy: a source of motivation when an individual receives a monetary transfer which is made conditional on performing certain health related actions.
Service infrastructure-information system: electronic health records, i.e., existence of and access to electronically retrievable health records at the point of healthcare delivery. It may also include the related training components. Electronic communication included computerized communication, telephone follow-up and counseling, interactive telephone systems, after-hours telephone access, and telephone screening
Facility-level inputs
Well performing and motivated workforce: included various strategies like support to manage and cope up with job, managing dual practice among healthcare workers, any form of exit interview undertaken at the time of departure from the organization. We also included interventions like changes in the organizational infrastructure, training methodologies, work environment or culture to improve the quality of care and healthcare worker performance, and audit and feedback.
Interpersonal care and social support: included interventions provided by professionals or non-professionals aimed at improving psychological well-being. These include various supportive interventions delivered in home visits, antenatal clinics or by telephone.
Safety culture: any interventions to enhance the safety of healthcare workers in healthcare environment. These included hand hygiene, interventions to reduce medication errors and influenza vaccination administered to health care professionals working in facility set-ups.
Staffing models: as the organizational interventions for nursing care like staffing levels, skill mix, qualification or grade mix, staff-patient ratios etc. We also included intervention to improve collaboration between two or more health and/or social care professionals.