Quality of Field Antenatal Clinics Services Checklist: A Valid and Reliable Tool for Quality Improvement

Abstract

The aim of this study was to develop and validate an instrument to measure the quality of services of a field antenatal clinic in Sri Lanka. The major steps on development of the tool were focus group discussions, expert opinion, homogeneity and multifactor dimensionality. The antenatal clinics in the Kalutara District were listed out into two groups; estate clinics and others. A sample of ten field antenatal clinics was selected randomly from the Kalutara district in Sri Lanka. In each of these ten clinics, 90 women were randomly selected to be observed. The Factor analysis was performed with principal component analysis on exploratory factor analysis with Varimax rotation. The Factor analysis resulted in a six factor structure; interaction, promotion and protection, information and counseling, comprehensive care and linkage, continuity of care and technical competence. Judgmental validity was ensured for the developed tool with the experts’ opinion and of which content validity was ensured by the process of tool development. Construct validity was ensured by factor analysis. Among six subscales, 3 (50%) subscales had a Cronbach’s alpha of 0.7 or greater. A statistically significant difference was not observed between the two groups of observers on all 6 subscales on the services checklist. Quality of field antenatal clinics services checklist (QFANCSC) is a valid and reliable tool, which can be used in future to assess the quality of antenatal services.