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Article History

Received: 31 August 2020

Accepted: 25 January 2021

First Online: 6 February 2021

Ethics approval and consent to participate

: The study and instruments were reviewed and approved by the IRB of Cayetano Heredia University (approval 043–04-19). Informed consent was obtained from facility directors and individual providers prior to observations commencing. Facility directors provided written consent for the facility to be included. Individual providers granted verbal informed consent as approved by the ethics committee in order to preempt provider concern that results of the observation could put them at risk.

: Not applicable.

: Dr. Leslie declares research support from the Bill & Melinda Gates Foundation, the World Bank, the World Health Organization, and ICF Macro during the course of this work. Employees of the Inter-American Development Bank provided input as noted in acknowledgements and authorship. The funding body played no other role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.