A new scale to assess health-facility level management: the development and validation of the facility management scale in Ghana, Uganda, and Malawi

The increased recognition of governance, leadership, and management as determinants of health system performance has prompted calls for research focusing on the nature, quality, and measurement of this key health system building block. In low- or middle-income contexts (LMIC), where facility-level management and performance remain a challenge, valid tools to measure management have the potential to boost performance and accelerate improvements. We, therefore, sought to develop a Facility-level Management Scale (FMS) and test its reliability in the psychometric properties in three African contexts. The FMS was administered to 881 health workers in; Ghana (n = 287; 32.6