Child and Maternal Mortality
in Islamic Countries
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3.1.3. Results from key informant interviews
To better understand the MNH situations in the country contexts and health system functioning,
we have conducted key informant interviews of stakeholders. The key informants were
identified by their track records on work in the MNCH area and their affiliations with the
relevant organizations. We have used a semi-structured questionnaire for a systematic
collection of standardized data with options for open-ended responses. We hypothesized that
answers from the key informants would mirror the overall picture of the health systems'
challenges.
We used the World Health Organization (WHO) framework to describe health systems
challenges. 50,51 The framework contains six core components or “building blocks”. These are
service delivery, health workforce, health information systems, access to essential medicines,
financing, and leadership/governance. We have interviewed 14 stakeholders from in-country
UN/WHO, World Bank/USAID/Developmental Agency, University/Research Institute, Non-
Governmental Organizations, etc. The majority of the respondents (9 out of 14 or 64.7%) have
been in their position within their organizations for 3 or more years.
Perceived functionality of WHO building blocks in the country
The WHO building blocks include service delivery, health workforce, health information
systems, access to essential drugs, financing, and leadership/governance. The responses were
rated as follows: 1= Best functioning; 2= Better functioning; 3= Functioning well; 4= Somewhat
functioning; 5= Worst / not functioning.
Based on the answers of the key informants, we calculated the perceived functionality mean
score for each building block and plotted it in a radar chart. The results are shown below. The
worst/least functional block has the highest mean score (higher score indicates poorer
performance).
The leadership/governance (mean score of 3.9) was identified as the “worst functioning” block.
This was reflected in some of the comments the informants made: “Leadership/Governance: The
planning process is so unlinked from outcomes, that it doesn't seem like what they are doing has
anything to do with where they want to go. On top of poor leadership, we have poor governance.
Leadership sometimes works, but it is individualized and can't be generalized. The worst thing is
we don't plan well, and if we plan the implementation falters because of poor governance”.
The ratings of other five blocks – service delivery and financing (3.1), health workforce and
health information systems (3.2), access to essential medicines (3.4) – were similar and ranked
them close to "functioning well."