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

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.