What does this research mean for the field?

In low- and middle-income countries, specific service readiness for sick child health services is positively associated with clinical quality of care but shows no correlation with user experience. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to describe service readiness in low- and middle-income countries and its impact on the quality of care and user experience for sick children.

May 17, 2026BMC Health Services Research0 citationsOpen Access

Specific service readiness for sick child health services and its relationship with quality of care and user experience in eight low-and middle-income countries

MLMengyao LiXi'an Jiaotong University LWLijian WangXi'an Jiaotong University XLXueli LiZhejiang Center for Disease Control and Prevention

Key Points

This research aims to describe service readiness in low- and middle-income countries and its impact on the quality of care and user experience for sick children.
Data was sourced from Service Provision Assessment surveys across eight LMICs.
Specific service readiness was measured using WHO assessments for facility preparedness.
Multilevel linear regression models analyzed the relationships between service readiness and both quality of care and user experience.
5,311 facilities and 20,880 sick child visits were analyzed.
The mean score for specific service readiness was 0.57, with staff and guidelines being the most limited.
Health providers performed an average of 5.77 out of 20 recommended actions, indicating suboptimal quality of care.

Abstract

BACKGROUND: General service readiness in health facilities often fails to predict the quality of care for sick child health services. This study aims to describe the specific service readiness in 8 low- and middle-income countries (LMICs) and examine its relationship with quality of care and user experience. METHODS: Data was drawn from the Service Provision Assessment surveys, comprehensive national health system assessments conducted within the last decade across Afghanistan, the Democratic Republic of the Congo, Ethiopia, Haiti, Malawi, Nepal, Senegal, and Tanzania. Specific service readiness was identified using the World Health Organization's Service Availability and Readiness Assessment, calculated as the mean preparedness across facilities. Quality of care was assessed by the number of actions in international guidelines that health providers performed. User experience was measured by reported client issues during visits. Multilevel linear regression models were performed testing the relationship between specific service readiness and quality of care and user experience. RESULTS: A total of 5,311 facilities and 20,880 sick child visits were analyzed. The mean score for specific service readiness was 0.57, with the staff and guidelines being the scarcest at 0.34. Health providers completed an average of 5.77 out of 20 recommended actions, indicating suboptimal quality. Interestingly, clients reported a higher user experience. Specific service readiness was positively related to the quality of care, but showed no correlation with user experience. CONCLUSIONS: Specific service readiness shows a notable association with the clinical quality of sick child health services in LMICs. Key strategies include staff training, improved availability of equipment and medications. Addressing these prerequisites may be associated with better health outcomes in sick child health services. CLINICAL TRIAL NUMBER: Not applicable.

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