scholarly journals 1369Probabilistic data linkage of health facility and individual data using PMA2020 surveys

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Cauane Blumenberg ◽  
Franciele Hellwig ◽  
Aluisio Barros
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Urban Areas ◽  
Performance Monitoring ◽  
Health Facilities ◽  
Sufficient Information ◽  
Public And Private ◽  
Individual Level ◽  
Match Rate ◽  
Probabilistic Linkage

Abstract Background Most studies rely on clustered analyses to study how the characteristics of health facilities influence individual outcomes. Our aim was to perform a probabilistic linkage between individual and health facility data to enable individual-level analyses. Methods We linked data from the most recent female questionnaire from 11 countries monitored by the Performance Monitoring for Action 2020 to a master health facility dataset (appending all rounds of surveys). Only women that reported which type of facility they visited were considered in the analysis. A probabilistic linkage was performed using 13 blocking variables (e.g., facility type and cluster of residence/location of the woman/facility) and 11 matching variables (e.g., types of contraceptive methods used/offered by the women/facility). Each concordant matching variable received a + 1 score, or a 0 score otherwise. We assessed linkage quality by pooled odds ratio of non-matches according to wealth tertiles (richest vs. poorest) and area of residence (urban vs. rural) using a meta-analytical approach. Results A total of 21,102 women and 7,056 facilities were considered in the linkage process. The average match rate was 57.9%, ranging from 42.5% in Indonesia to 69.1% in Burkina Faso. The pooled odds of non-match were 74% higher for the richest women compared to the poorest, and 67% higher for women living in urban areas compared to rural areas. Conclusions High match rates were achieved in countries with sufficient information on public and private facilities. The lack of information about private facilities contributed to the higher odds of non-match among the better off. Key messages We performed a probabilistic linkage approach to link individual and health facility data, making it possible to understand how the characteristics of health facilities can influence individual-level outcomes. Our findings also bring light to the importance of sampling both public and private facilities, aiming to maximise match rates and reduce differences on match rates according to socio demographic characteristics of the sample.

scholarly journals A temporal analysis of maternal deaths in some selected health facilities in Zamfara State, Northwest Nigeria: How far were United Nations Millennium Development Goals (MDG) 5 achieved?

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Abdullahi Mohammed Maiwada ◽  
Nor Azlina A Rahman ◽  
Suzanah Abdul Rahman ◽  
Nik Mazlan Mamat ◽  
Tukur A Baba ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Rural Areas ◽  
Urban Areas ◽  
Maternal Mortality Ratio ◽  
Temporal Analysis ◽  
Health Facilities ◽  
Steady Increase ◽  
Maternal Deaths ◽  
Mortality Ratio

Introduction: The steady increase in maternal deaths in Nigeria is a serious source of concern to policy makers and key stakeholders as one of the major threats to the achievement of the MDGs. Nigeria is reported to have one of the highest maternal mortality ratios in the world. This study was aimed at examining the challenges confronting the achievement of the MDGs Goals 5 in Zamfara State northwest Nigeria in terms of maternal mortality ratio, causes and frequency of antenatal visits. Methods: Health facility based approach and statistics were used in assessing maternal mortality ratio. Data was collected from health facility records and folders of patients who lost their lives due to pregnancy and childbirth related illnesses in some selected health facilities in Zamfara State from 2011- 2015. Results: The results showed the highest maternal deaths are in the rural areas 5120/100,000 as compared to 750/100,000 urban health facilities. Haemorrhage was the leading medical cause of maternal death. Others include sepsis, eclampsia, sickle cell anaemia, obstructed labour and abortion. However, there was a significant increase in the number of antenatal care visits from 7.20% to 30.93% within the last five years. However, the maternal mortality rate has increased, though not stable from 735/100,000 in 2011 to 1248/100,000 in 2013 and 930/100,000 in mid-2015. Conclusions: There was an increase in maternal deaths in rural compared to urban areas health clinics despite increased in the attendance of ante natal care visits thus the 5th Millennium Development Goal in Zamfara State not achieved.

scholarly journals The Role of Health Facilities in Supporting Adherence to Iron-folic Acid in Haiti and Malawi: A Study Linking Health Facility Survey and Population Survey Data

2020 ◽  
Author(s):  
Wenjuan Wang ◽  
Rukundo Benedict ◽  
Lindsay Mallick
Keyword(s):  
Folic Acid ◽  
Health Facility ◽  
Rural Areas ◽  
Urban Areas ◽  
Health Facilities ◽  
Demographic And Health Surveys ◽  
Related Services ◽  
Iron Folic Acid ◽  
Facility Survey ◽  
High Level

Abstract Background: Iron-folic acid (IFA) supplementation during pregnancy is key to prevent maternal anemia. In Malawi and Haiti, consumption of IFA supplements remains suboptimal. This study examined the IFA-related services provided in health facilities and their association with women’s adherence to IFA supplementation during pregnancy.Methods: This study used data from the Demographic and Health surveys (DHS) and the Service Provision Assessment (SPA) in Haiti and Malawi. Using GPS data collected in both surveys, each DHS cluster was linked to health facilities surveyed in the SPA within a specified buffer distance (5 km for urban areas and 10 km for rural areas). IFA-related services were examined for health facilities within the buffer, including the availability of IFA supplements, prescription of IFA, and client counseling on IFA. Adherence to IFA supplementation was examined for women who received antenatal care (ANC) for their most recent live birth in the 2 years preceding the DHS survey. Multilevel logistic regressions stratified by urban and rural locale were used to model associations between women’s consumption of IFA supplements and the health facility service environment, controlling for relevant covariates.Results: More than two-thirds of facilities with ANC services in Haiti and almost all ANC facilities in Malawi had IFA supplements available. Over 60% of ANC clients in Haiti and over 80% in Malawi received IFA supplements or an IFA prescription. Counseling on IFA was less common and focused on how to use IFA; few women were counseled on side effects. Only 42% of women in Haiti and 35% of women in Malawi took IFA supplements for at least 90 days. Multivariable models indicated that in both countries, adherence to IFA supplementation in rural areas was significantly associated with a high level of availability of ANC facilities offering IFA. IFA counseling was also positively associated with the IFA supplement adherence in rural Malawi but not in Haiti. IFA supplement adherence was consistently associated with the completion of four or more ANC visits in both countries.Conclusions: Continued efforts are required to address access to IFA supplements through improving both the use of ANC services and their quality, particularly in provider counseling.

High prevalence of cesarean section delivery among health facilities delivered mothers in Bahir Dar city, Amhara region, Ethiopia. A comparative study

2019 ◽  
Author(s):  
Meseret Bantigegn Melesse ◽  
Alehegn Bishaw Geremew ◽  
Solomon Mekonnen Abebe
Keyword(s):  
Cesarean Section ◽  
Health Facility ◽  
Health Facilities ◽  
Public Facility ◽  
Bahir Dar ◽  
Amhara Region ◽  
Public And Private ◽  
Cesarean Section Delivery ◽  
Private Health Facility ◽  
Significant Difference

Abstract Background Cesarean section delivery prevalence rate has been in an alarming increase worldwide each year; there are large disparities of CS proportion among women who give birth at a public and private health facility. However, there is a lack of evidence regarding the underlying factors and the proportion of CS delivery in public and private health facilities. Therefore this study aimed to asses and compare the prevalence of CS delivery and associated factors among public and private health facilities delivered mother in Bahir Dar city, Amhara region, Ethiopia, Methods An institution-based comparative cross-sectional study design was conducted from March1-April 15, 2019 health facility in Bahir Dar city. Study participants 724(362 for each public and private facility) were recruited through a systematic random sampling technique. Structured interview administered questionnaires and chart review checklist were used to collect data. The data were entered with Epi info version 7.2 and analyzed using SPSS version 23.0 software. A binary logistic regression model was fitted and an adjusted odds ration with 95% CI was used to determine the presence and strength of association between independent variables and cesarean section delivery. Results The response rate was 98.3% and 97.2% for public and private health facilities respectively. The prevalence of CS in private health facilities was198 (56.3%) (95%CI: 50.9, 61.4) and 98 (27.5%) (95%CI: 22.8, 32.2) was in public health facilities. Overall prevalence of CS delivery was 296(41.8%) (95% CI: 38.4, 45.5). Breech presentation (AOR=3.64; 95%CI (1.49, 8.89), urban residence (AOR=6.54; 95%CI (2.59, 16.48) and being referred (AOR=2.44; 95%CI (1.46, 4.08)were variables significantly associated with CS among public facility whereas age between 15-24 (AOR=0.20, 95% CI; 0.07,0.52),governmental employee (AOR=2.28;95%CI (1.39,3.75),self-employed (AOR=3.73;95%CI(1.62,8.59),Para one(AOR=6.79;95%CI(2.02,22.79) Para two (AOR=3.88;95% CI(1.15,13.08), and wealth index being highest level of wealth asset AOR=5.39; 95%CI (1.08, 26.8) in private health facility: Conclusion and recommendation We concluded that there is a statistically significant difference in the prevalence of CS delivery in public and private health facilities. Therefore, there should be a mechanism for a medical audit of labor management.

Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study

2020 ◽  
Author(s):  
Richard Mugambe ◽  
Habib Yakubu ◽  
Solomon Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Public Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Cross Sectional ◽  
Western Uganda ◽  
Delivery Place

Abstract Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Kwikiriza Magambo ◽  
Francis Bajunirwe ◽  
Fred Bagenda
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Health Workers ◽  
Geographic Location ◽  
Health Facilities ◽  
Urban Setting ◽  
World Health ◽  
Program Performance ◽  
Immunization Program ◽  
Western Uganda

Abstract Background Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings.

scholarly journals Prevalence and Determinants of Rural-Urban Utilization of Skilled Delivery Services in Northern Ghana

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Mahama Saaka ◽  
Jones Akuamoah-Boateng
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Northern Region ◽  
Northern Ghana ◽  
Skilled Delivery ◽  
Birth Attendance ◽  
Delivery Services ◽  
Study Population

Background. There are wide differences in the uptake of skilled delivery services between urban and rural women in the northern region of Ghana. This study assessed the rural-urban differences in the prevalence of and factors associated with uptake of skilled delivery in the northern region of Ghana. Methods. The study population comprised postpartum women who had delivered within the last three months prior to the study. The dataset was analyzed using the chi-square test and multivariable logistic regression. Results. The odds of skilled birth attendance (SBA) adjusted for confounding variables in urban areas were higher compared with their rural counterparts (AOR = 1.59; CI: 1. 07–2.37; p=0.02). The determinants of skilled delivery were similar but of different levels and strength in rural and urban areas. The main drivers that explained the relatively high skilled delivery coverage in the urban areas were higher frequency of antenatal care (ANC) attendance, proximity (physical access) to health facility, and greater proportion of women attaining higher educational level of at least secondary school. Distance from health facility less than 4 km was the greatest independent contributor to the variance in skilled delivery in the urban areas, whereas frequency of ANC attendance was the greatest independent contributor in the rural areas. Conclusions. This study identified underlying determinants accounting for rural-urban differences in skilled delivery, and covariate effect was more dominant than coefficient effect. Therefore, urban-rural differences in SBA outcomes were primarily due to differences in the levels of critical determinants rather than the nature of the determinants themselves. Therefore, improving skilled delivery outcomes in this study population and other similar settings will not require different policy frameworks and interventions in dealing with rural-urban disparities in SBA outcomes. However, context-specific tailored approaches and strategies including targeting mechanisms have to be designed differently to reduce the rural-urban differences.

scholarly journals Mapping poverty using mobile phone and satellite data

2017 ◽  
Vol 14 (127) ◽  
pp. 20160690 ◽  
Author(s):  
Jessica E. Steele ◽  
Pål Roe Sundsøy ◽  
Carla Pezzulo ◽  
Victor A. Alegana ◽  
Tomas J. Bird ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Census Data ◽  
Data Sources ◽  
Human Potential ◽  
Public And Private ◽  
Middle Income ◽  
Mobile Data ◽  
Poverty Measures ◽  
Urban And Rural Areas

Poverty is one of the most important determinants of adverse health outcomes globally, a major cause of societal instability and one of the largest causes of lost human potential. Traditional approaches to measuring and targeting poverty rely heavily on census data, which in most low- and middle-income countries (LMICs) are unavailable or out-of-date. Alternate measures are needed to complement and update estimates between censuses. This study demonstrates how public and private data sources that are commonly available for LMICs can be used to provide novel insight into the spatial distribution of poverty. We evaluate the relative value of modelling three traditional poverty measures using aggregate data from mobile operators and widely available geospatial data. Taken together, models combining these data sources provide the best predictive power (highest r 2 = 0.78) and lowest error, but generally models employing mobile data only yield comparable results, offering the potential to measure poverty more frequently and at finer granularity. Stratifying models into urban and rural areas highlights the advantage of using mobile data in urban areas and different data in different contexts. The findings indicate the possibility to estimate and continually monitor poverty rates at high spatial resolution in countries with limited capacity to support traditional methods of data collection.

scholarly journals Geographical perspective of modeling primary healthcare accessibility

2017 ◽  
Vol 10 (1) ◽  
pp. 56-67 ◽  
Author(s):  
Justice Surage ◽  
Richard Tawiah ◽  
Timothy Twumasi-Mensah
Keyword(s):  
Health Facility ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Content Type ◽  
Central District ◽  
Healthcare Accessibility

Purpose The purpose of this paper is to measure the spatial accessibility of primary healthcare facility in Ghanaian rural areas, by determining the barriers to healthcare accessibilities in the Amansie Central District. Design/methodology/approach Both network and proximity analyses were performed on the digitized data such as road networks, settlements, population, district boundary, natural resources (rivers, streams and forest) and site location (health facilities). To quantify the population who have access to healthcare the authors used the Ghana Health Service access criteria that health facility should be accessible to an estimated population within 8 km radius from the facility. Findings The overall mean distance to the nearest health facility in the district was 8.9 km. Fiankoma sub-district recorded the highest mean distance whereas Tweapease sub-district recorded the least. In general, 31.2 percent of the district population has no access to healthcare facility. Transportation was identified to be one of the major hindrances to healthcare accessibility and this was as a result of poor road network in the district. Research limitations/implications The study was restricted to the Amansie Central District of Ghana. This limits the extent of generalization of results. Originality/value The study proposed additional sites for siting new health facilities base on criteria such as population, distance, centrality and existing infrastructural development. This will consequently improve healthcare accessibility and utilization by increasing total coverage closer to 100 percent.

scholarly journals Factors affecting health care facility utilization in rural areas of Lucknow district

2018 ◽  
Vol 5 (5) ◽  
pp. 1766
Author(s):  
Vinita Shukla ◽  
Pratibha Gupta
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Facility ◽  
Rural Areas ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Public And Private ◽  
Background Population

Background: Population is increasing rapidly so with the limited resources government alone cannot cater the health of whole population. Private health sector is equally important for the improvement of health of the people. In view of these facts the present study was planned to assess the utilization of health care services (both public and private) and to assess the reasons for visiting that particular health facility (public or private).Methods: Study was cross sectional for 1 year period. Total sample size was 1024. In the present study only rural area was taken. By using multistage stratified random sampling 6 villages were selected and sample came out as 516. Data was analyzed by stata software version -12 for windows and chi square test.Results: 50% respondents visited public, 38% private and 10% visited others (charitable, pharmacies etc.). 62% respondents belonged to lower socio economic status preferred public health care facility. The main reason for visiting public health facility was free services and for private was got cure earlier from that heath facility. Majority of people visited any health facility for illness. (344 out of 516) and 50% of them visited for respiratory diseases. For chronic illness majority (60%) preferred public health care facility.Conclusions: Both public and private health care facilities should be made well equipped and affordable so that people can make choices and not forced to choose particular health facility.

scholarly journals Performance monitoring and accountability: The Agile Project’s protocol, record and experience

2020 ◽  
Vol 4 ◽  
pp. 30
Author(s):  
Amy Tsui ◽  
Philip Anglewicz ◽  
Titilope Akinlose ◽  
Varsha Srivatsan ◽  
Pierre Akilimali ◽  
...  
Keyword(s):  
Performance Monitoring ◽  
Democratic Republic Of Congo ◽  
Total Sample ◽  
Health Facilities ◽  
Childbearing Age ◽  
Public And Private ◽  
Male Clients ◽  
Early Experiences ◽  
Female Clients

The Performance Monitoring and Accountability 2020 (PMA2020) project implemented a multi-country sub-project called PMA Agile, a system of continuous data collection for a probability sample of urban public and private health facilities and their clients that began November 2017 and concluded December 2019.  The objective was to monitor the supply, quality and consumption of family planning services.  In total, across 14 urban settings, nearly 2300 health facilities were surveyed three to six times in two years and a total sample of 48,610 female and male clients of childbearing age were interviewed in Burkina Faso, Democratic Republic of Congo, India, Kenya, Niger and Nigeria.  Consenting female clients with access to a cellphone were re-interviewed by telephone after four months; two rounds of the client exit, and follow-up interviews were conducted in nearly all settings.  This paper reports on the PMA Agile data system protocols, coverage and early experiences.  An online dashboard is publicly accessible, analyses of measured trends are underway, and the data are publicly available.

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