Table 2 Factor analysis for the 16 item governance score

The health facilities receive regular external quality check team to ensure that the protocols and standards are followed.

The allocation and utilization of resources are regularly tracked and information on results is available for review by the local communities/stakeholder.

There is a mechanism for correcting those not complying with standards and code of conduct.

The public and concerned stakeholders have the capacity to advocate and participate effectively with the health facility officials in making plans.

There are procedures and systems that clients, providers, and concerned stakeholders can use to fight bias and inequity in accessing health service.

Health services are organised and financed in ways that offer incentives to health workers and community health workers to improve performance.

The facility managers ensure that Health workers follow protocols, standards and codes of conduct.

The health facility collects and analyses local data.

Local organisations and health service users have influence on what services are offered at the health facility.

There are forums and procedures that give the public, technical experts, and local communities’ opportunities to provide input.

The health facility use evidence on program results, patient satisfaction, and other health-related information to improve the services they deliver.

Health facility managers rely on research data from health facility to plan services.

The health facility regularly organize forums to solicit input from the public and concerned stakeholders.

The health facility has protocols for adult, child and maternal health services from the MoH.

Systems exist for reporting, investigating, and adjudicating misallocation or misuse of resources.

The public/concerned stakeholders have regular opportunities to meet with managers of the health facility to raise issues about service efficiency or quality.