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Table 3 Internal structure and internal consistency for COACH version V tool, phase VI

From: Health system context and implementation of evidence-based practices—development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

    Rotated component matrixa Cronbach’s alpha Corrected total item correlation Average inter-item correlation
    1 2 3 4 5 6 7 8 9 10 11    
Resources My unit has enough workers with the right training and skills to do everything that needs to be done Human resources            0.84 0.84 0.40–0.66 0.32
My unit has enough workers with the right training and skills to do their job in the best possible way Human resources            0.86
My unit has enough space to provide healthcare services Space            0.47
My unit has access to the transport and fuel that are needed to provide healthcare services Communication and transport       0.66      
My unit has access to the communication tools (e.g. telephones or radios) that are needed to provide healthcare services Communication and transport       0.72      
My unit receives money according to a budget Financing       0.52      
My unit has money that we can decide how to use Financing       0.57      
My unit has enough medicine to provide healthcare services Medicines and equipment        0.80     
My unit has enough functional equipment to provide healthcare services Medicines and equipment        0.76     
My unit has enough disposable medical equipment, such as syringes, gloves and needles to provide healthcare services Medicines and equipment        0.76     
If the workload increases, my unit can get additional resources such as medicine and equipment Medicines and equipment        0.70     
Community engagement In my unit, we ask community members what they think about the healthcare services that we provide      0.72         0.83 0.58–0.66 0.49
In my unit, we listen to what community members think about the healthcare services we provide      0.72        
In my unit, we have meetings with community members to discuss health matters      0.75        
In my unit, we encourage community members to contribute to improving the health of the community      0.74        
In my unit, we encourage other organizations to contribute to improving the health of the community      0.67        
Monitoring services for action I receive regular updates about my unit’s performance based on information/data collected from our unit       0.70        0.84 0.57–0.70 0.53
My unit discusses information/data from our unit in a regular, formal way, such as in regularly scheduled meetings       0.70       
My unit regularly uses unit information/data to make plans for improving its healthcare services       0.67       
My unit regularly monitors its work by comparing it with the unit’s action plans       0.70       
My unit regularly compares its work with national or other guidelines       0.68       
Sources of knowledge Clinical practice guidelines Structural sources           0.78   0.69 0.38–0.49 0.31
Other printed material for work (e.g. textbooks, journals) Structural sources           0.73  
In-service training/ workshops/courses Structural sources           0.69  
The Internet E-health       0.71      
Electronic decision support (e.g. mobile phone applications or other electronic devices to assist with care and decision-making) E-health       0.65      
Commitment to work I am proud to work in this unit.          0.70     0.76 0.55–0.62 0.52
I am satisfied to work in this unit.          0.76    
I feel encouraged to do my very best at work.          0.72    
Work culture My unit is willing to use new healthcare practices such as guidelines and recommendations Culture of learning and change    0.69          0.83 0.56–0.65 0.45
My unit helps me to improve and develop my skills Culture of learning and change    0.57         
I am encouraged to seek new information on healthcare practices Culture of learning and change    0.75         
My unit works for the good of the clients and puts their needs first Culture of responsibility    0.65         
Members of the unit feel personally responsible for improving healthcare services Culture of responsibility    0.59         
Members of the unit approach clients with respect Culture of responsibility    0.54         
Leadership I trust the unit leader.   0.59            0.89 0.61–0.80 0.59
The leader handles stressful situations calmly.   0.80           
The leader actively listens, acknowledges, and then responds to requests and concerns.   0.82           
The leader effectively resolves any conflicts that arise.   0.80           
The leader encourages the introduction of new ideas and practices.   0.75           
The leader makes things happen.   0.73           
Informal payment Clients must always give informal payment to health workers to access healthcare services Informal payment   0.78           0.77 0.31–0.60 0.32
Clients are treated more quickly if they make informal payments to health workers Informal payment   0.83          
Medicines or equipment that should be available for free to clients have been sold in my unit Informal payment   0.78          
Health workers are sometimes absent from work earning money at other places Informal payment   0.73          
Health workers in my unit give healthcare services to friends and family first Nepotism   0.68          
Health workers in my unit give jobs or other benefits to friends and family first Nepotism   0.64          
Efforts are made to stop clients from providing informal payment to get appropriate healthcare services Accountability          0.87   
  Efforts are made to stop health workers from asking clients for informal payment Accountability          0.86      
  1. Extraction method: principal component analysis. Rotation method: Varimax with Kaiser Normalization
  2. aRotation converged in eight iterations