The Demographic and Health Surveys (DHS) Program, Avenir Health, Rockville, MD, United States of America.
Program Assistance, Design, Monitoring and Evaluation for Sustainable Development (PADMES), ICF, Washington, DC, United States of America.
PLoS One. 2019 Jun 7;14(6):e0217547. doi: 10.1371/journal.pone.0217547. eCollection 2019.
Measuring quality of care in family planning services is essential for policymakers and stakeholders. However, there is limited agreement on which mathematical approaches are best able to summarize quality of care. Our study used data from recent Service Provision Assessment surveys in Haiti, Malawi, and Tanzania to compare three methods commonly used to create summary indices of quality of care-a simple additive, a weighted additive that applies equal weights among domains, and principal components analysis (PCA) based methods. The PCA results indicated that the first component cannot sufficiently summarize quality of care. For each scoring method, we categorized family planning facilities into low, medium, and high quality and assessed the agreement with Cohen's kappa coefficient between pairs of scores. We found that the agreement was generally highest between the simple additive and PCA rankings. Given the limitations of simple additive measures, and the findings of the PCA, we suggest using a weighted additive method.
衡量计划生育服务质量对于政策制定者和利益相关者至关重要。然而,对于哪种数学方法最能概括服务质量,目前尚未达成共识。我们的研究使用了来自海地、马拉维和坦桑尼亚最近的服务提供情况评估调查的数据,比较了三种常用于创建服务质量综合指数的方法:简单加总法、对各领域赋予相同权重的加权加总法和基于主成分分析(PCA)的方法。PCA 结果表明,第一个成分无法充分概括服务质量。对于每种评分方法,我们将计划生育设施分为低、中、高质量,并使用 Cohen's kappa 系数评估两个评分之间的一致性。我们发现,简单加总法和 PCA 排名之间的一致性通常最高。鉴于简单加总法的局限性和 PCA 的发现,我们建议使用加权加总法。