Each of these factors can exhibit incidental or structural deficiencies (whether or not through insufficient use) that contribute to substandard care and adverse outcomes.
A maternity services' audit in Malawi found that poor documentation, delays in recognising the severity of the clinical condition, delays in adequate treatment and preoperative resuscitation with delays in referral, contributed to substandard care [ 18].
In Egypt, for example, a national confidential inquiry found that 43 % of avoidable factors contributing to maternal mortality were due to substandard care by the obstetric team [ 17, 18].
Low work standards and inadequate job/task/tool design were frequently noted as the basic cause while the most common substandard actions contributing to the incident were workers being inattentive to ambient job hazards and utilizing unsafe work positions.
Substandard care factors contributing to deaths were identified in 116 (82.3%) of all cases.
On the other hand, the presence of at least one administration related substandard care in 60% of the cases suggests serious weakness of the health care systems, contributing to the burden of adverse maternal outcome in resource limited countries.
A substandard drug in wide circulation will inevitably contribute to disease transmission and was undoubtedly a factor contributing to this epidemic.
In the mid- to late 1990s, however, several maquiladoras in Honduras, Mexico, and the Dominican Republic were criticized for substandard working conditions and excessively long workweeks (up to 75 hours, without overtime compensation) as well as for contributing to environmental pollution.
Like most of the existing observational instruments in healthcare, SHAPE uses behavioural markers, defined as 'observable non-technical behaviours that contribute to superior or substandard performance within a work environment'.
Some said using substandard products contributed to the provision of poor quality care to clients.
