Identifying Critical Issues in the Perception of Caregivers about Quality of Child Health Care Services Using a Modified Delphi Technique

Background: Identification of the elements of the perception users of health services is a critical step in the development of measurement scales to assess such perception. This study is the second of a three phase approach to create a validated tool for the assessment of caregiver’s perceived quality of child health care in Primary health care (PHC) facilities. The first phase was exploratory using qualitative methods to assess the perceptions of caregivers about quality of child health care services; it yielded 39 quality-of-care items. Method: In this current study, we subjected the 39 quality of care items to expert review using the modified Delphi method. This method is useful for providing evidence for content validity in quantitative scale design. A total of 33 experts, including public health specialists, pediatricians and medical sociologists, participated in three iterative rounds. In each round the experts awarded score to the items and consensus amongst experts was determined by calculating inter quartile range of the assigned scores. Results: At the end of the three rounds of expert review, the total number of question items that had shown consensus considerably amongst the expert reviewers was 23. Conclusion: For these 23 items, a three point Likert scale response format was framed appropriately as a quantitative scale for assessing perceived quality of child health services in PHC facilities.