scholarly journals Scaling Up a Strengthened Youth-Friendly Service Delivery Model to Include Long-Acting Reversible Contraceptives in Ethiopia: A Mixed Methods Retrospective Assessment

2019 ◽  
Vol 9 (2) ◽  
pp. 53-64
Author(s):  
Fariyal F. Fikree ◽  
Habtamu Zerihun
Keyword(s):  
Scale Up ◽  
Scaling Up ◽  
Health Facilities ◽  
Health Centers ◽  
Financial Resources ◽  
Up Elements ◽  
Long Acting ◽  
Youth Friendly Service ◽  
Youth Friendly

Background: Donor funded projects are small scale and time limited, with gains that soon dissipate when donor funds end. This paper presents findings that sought to understand successes, challenges and barriers that influence the scaling up and sustainability of a tested, strengthened youth-friendly service (YFS) delivery model providing an expanded contraceptive method choice in one location – the YFS unit – with additional units in Amhara and Tigray, Ethiopia. Methods: This retrospective mixed methods study included interviews with key informants (KIs) (qualitative arm) and analysis of family planning (FP) uptake statistics extracted from the sampled health facilities (quantitative arm). A multistage convenience purposive sampling technique was adopted to randomly select 8 health facilities aligned with respective woredas, zones and regional health bureaus (RHBs). A semi-structured interview guide soliciting information on 6 scaling-up elements (stakeholder engagement, roles and responsibility, policy environment, financial resources, quality of voluntary FP services and data availability and use) guided the interviews. Fifty-six KI interviews were conducted with policy-makers, program managers, and clinic staff. Recurring themes were triangulated across administrative levels and implementing partners. Relevant FP data (acceptor status, age and method uptake) were extracted from the 8 sampled health facilities for a thirteen-month period. Qualitative findings triangulated with FP service statistics assessed the influence of the 6 scaling-up elements with trends in long-acting reversible contraceptive (LARC) uptake before and after training. Results: Our findings depict that respondents were knowledgeable and supportive of an expanded method mix. Statistically significant increases in long-acting contraceptive uptake were noted at 2 of the 8 health centers. Fidelity to the tested model was operationally constrained; respondents frequently mentioned trained staff absences and turnover as obstacles in offering quality FP services. Conclusion: Despite conducive policy environment, supportive stakeholders, favorable environment, and financial support for trainings, statistically significant increases in LARC uptake occurred at only 2 of the 8 health centers; indicating the influence of weak health systems, poor quality of voluntary FP services and a ceiling effect. Scale-up processes must consider potential bottlenecks of weak health systems and availability of financial resources by addressing these as crucial elements in any systematic scale-up framework.

scholarly journals Public Reproductive Health Facilities: A Client-Satisfaction Survey

2016 ◽  
Vol 9 (2) ◽  
pp. 208
Author(s):  
Fariba Moradi ◽  
Zohreh Balaghi ◽  
Mohsen Moghadami ◽  
Hassan Joulaei ◽  
Najaf Zare
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Quality Of Health Care ◽  
Client Satisfaction ◽  
Service Providers ◽  
Health Facilities ◽  
Health Centers ◽  
Significant Difference ◽  
Improvement Programs

<p><strong>INTRODUCTION:</strong> Understanding clients’ perspectives on quality improvement programs is essential to achieve the goals of health services. Determining client satisfaction could help decision makers to implement programs fit to their needs as perceived by service providers and clients. This study aimed to assess the level of satisfaction among women attending health centers regarding the services received in governmental health facilities in Shiraz, southern Iran.</p><p><strong>METHOD:</strong> This cross-sectional study was performed in 24 urban health centers. Using systematic random sampling method, 8 clinics were assigned to each group. Then questionnaires were distributed among 240 married women in 15-49 year-old age group who had referred to selected clinics for receiving some services. For data analysis, SPSS version 15 software and Chi-square statistical procedure were used to evaluate clients’ satisfaction.</p><p><strong>RESULTS:</strong> Data showed that 101 out of 240 respondents were completely satisfied with the personnel as well as the health center. Furthermore, satisfaction was found to be the highest among clients of those centers ranked as middle class socioeconomic status, while no significant difference was found between centers based on their socioeconomic status.</p><p><strong>CONCLUSION: </strong>The results of the present study would enable policy-makers to effectively improve the quality of health care, keeping a balance between providers’ and patients’ perspectives on the quality of health care.</p>

A systematic review of costing studies for implementing and scaling-up breastfeeding interventions: what do we know and what are the gaps?

2020 ◽  
Vol 35 (4) ◽  
pp. 461-501 ◽  
Author(s):  
Grace Carroll ◽  
Cara Safon ◽  
Gabriela Buccini ◽  
Mireya Vilar-Compte ◽  
Graciela Teruel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternity Leave ◽  
Grey Literature ◽  
Scale Up ◽  
Scaling Up ◽  
World Health ◽  
Future Research ◽  
Cost Estimates ◽  
Costing Study

Abstract Despite the well-established evidence that breastfeeding improves maternal and child health outcomes, global rates of exclusive breastfeeding remain low. Cost estimates can inform stakeholders about the financial resources needed to scale up interventions to ultimately improve breastfeeding outcomes in low-, middle- and high-income countries. To inform the development of comprehensive costing frameworks, this systematic review aimed to (1) identify costing studies for implementing or scaling-up breastfeeding interventions, (2) assess the quality of identified costing studies and (3) examine the availability of cost data to identify gaps that need to be addressed through future research. Peer-reviewed and grey literature were systematically searched using a combination of index terms and relevant text words related to cost and the following breastfeeding interventions: breastfeeding counselling, maternity leave, the World Health Organization International Code of Marketing of Breastmilk Substitutes, the Baby-Friendly Hospital Initiative, media promotion, workplace support and pro-breastfeeding social policies. Data were extracted after having established inter-rater reliability among the first two authors. The quality of studies was assessed using an eight-item checklist for key costing study attributes. Forty-five studies met the inclusion criteria, with the majority including costs for breastfeeding counselling and paid maternity leave. Most cost analyses included key costing study attributes; however, major weaknesses among the studies were the lack of clarity on costing perspectives and not accounting for the uncertainty of reported cost estimates. Costing methodologies varied substantially, standardized costing frameworks are needed for reliably estimating the costs of implementing and scaling-up breastfeeding interventions at local-, national- or global-levels.

scholarly journals Quality of Medical Records in Public Health Facilities of Jimma Zone, Oromia Regional State, Southwest, Ethiopia 2021

2021 ◽  
Author(s):  
Nigusu Endashaw ◽  
Bezawit Birhanu ◽  
Melese Teka ◽  
Gelila Abrham
Keyword(s):  
Public Health ◽  
Medical Records ◽  
Quantitative Data ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional ◽  
Southwest Ethiopia ◽  
Public Health Facilities ◽  
Jimma Zone

Abstract Background: Comprehensive medical records are cornerstones in the quality and efficiency of patient care, as they can provide a complete and accurate chronology of treatments, patient results, and future plans for care. The study was aimed to assess the quality of medical records in public health facilities of Jimma Zone. Methods: A facility-based cross-sectional quantitative study design supplemented by a qualitative method was used from May 30 to July 29, 2020. A total of 384 medical records were reviewed by using the facility inventory form for quantitative data. The data was entered by EPI data 3.1 and analyzed by SPSS 23 and descriptive statistics were used to present the findings. Qualitative data were triangulated with the quantitative data.Result: The majority of the health facility has a shortage of trained and qualified recording personnel in the medical record department. Among 36 health facilities, only one facility have printer in the record room and 3(8%) of them have tracer card. The overall quality of medical records in terms of content completeness as per the standard of health facilities requirements for districts, hospitals, and health centers were 30.62%, 39.49%, 25.79% respectively. Conclusion: The majority of medical records had poor completeness of administrative data, clinical, financial, and legal contents. The overall quality of medical records in Jimma Zone was very low for components of the quality of medical records as per the standard of health facilities requirements.

scholarly journals Health system capacity for tuberculosis care in Ethiopia: evidence from national representative survey

2020 ◽  
Vol 32 (5) ◽  
pp. 306-312
Author(s):  
Amare Deribew ◽  
Tariku Dejene ◽  
Atkure Defar ◽  
Della Berhanu ◽  
Sibhatu Biadgilign ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health System ◽  
Health Facilities ◽  
Public Hospitals ◽  
Health Centers ◽  
System Capacity ◽  
Public And Private ◽  
Southwestern Ethiopia ◽  
Care Capacity

Abstract Objective The objective of this study was to evaluate the tuberculosis (TB) health system capacity and its variations by location and types of health facilities in Ethiopia. Design We used the Service Provision Assessment plus (SPA+) survey data that were collected in 2014 in all hospitals and randomly selected health centers and private facilities in all regions of Ethiopia. We assessed structural, process and overall health system capacity based on the Donabedian quality of care model. Multiple linear regression and spatial analysis were done to assess TB capacity score variation across regions. Setting The study included 873 public and private health facilities all over Ethiopia. Participants None. Intervention(s) None. Main outcome measure(s) None. Results A total of 873 health facilities were included in the analysis. The overall TB care capacity score was 76.7%, 55.9% and 37.8% in public hospitals, health centers and private facilities, respectively. The health system capacity score for TB was higher in the urban (60.4%) facilities compared to that of the rural (50.0%) facilities (β = 8.0, 95% CI: 4.4, 11.6). Health centers (β = −16.2, 95% CI: −20.0, −12.3) and private health facilities (β = −38.3, 95% CI: −42.4, −35.1) had lower TB care capacity score than hospitals. Overall TB care capacity score were lower in Western and Southwestern Ethiopia and in Benishangul-Gumuz and Gambella regions. Conclusions The health system capacity score for TB care in Ethiopia varied across regions. Health system capacity improvement interventions should focus on the private sectors and health facilities in the rural and remote areas to ensure equity and improve quality of care.

Scaling up Process Output of Monomer Reactor

2013 ◽  
Vol 748 ◽  
pp. 299-303 ◽  
Author(s):  
Anika Zafiah M. Rus ◽  
Muhamad Soqhimi Mohamad Isa ◽  
Nurul Saidatul Syida Sulong
Keyword(s):  
Scale Up ◽  
Scaling Up ◽  
Pilot Scale ◽  
Industrial Scale ◽  
Important Process ◽  
Laboratory Equipment ◽  
Cooking Oil ◽  
Used Cooking Oil ◽  
Process Output

A monomer processing reactor is a device to process used cooking oil into new substance that can be used for other applications. In this study, used cooking oil was converted to monomer via simple reactor comprised of stirrer started with laboratory scale of 2L to 5L of monomer production. A scale up process is an important process for approaching industrial scale productions. The scale up process was increased to pilot scale before it reaches to industrial scale. The reactor is designed based on lab scale process for producing monomer from used cooking oil. The most important point of the device design is to produce larger amount of monomer compared to lab scale equipment. The device can produce 15liters of monomer per production. The monomer has the same properties and quality of monomer that were produced using laboratory equipment.

scholarly journals Scaling up HIV viral load monitoring in Manicaland, Zimbabwe: challenges and opportunities from the field

2019 ◽  
Vol 9 (4) ◽  
pp. 177-181
Author(s):  
B. Nyagadza ◽  
N. Kudya ◽  
E. Mbofana ◽  
S. Masaka ◽  
D. Garone ◽  
...  
Keyword(s):  
Viral Load ◽  
Scale Up ◽  
Scaling Up ◽  
Health Facilities ◽  
Hiv Viral Load ◽  
Care Workers ◽  
Challenges And Opportunities ◽  
Load Monitoring ◽  
Switch Rate ◽  
Testing Coverage

Background: Demand for viral load (VL) monitoring is expected to increase; however, implementation of the multifaceted VL testing poses numerous challenges. We report experiences from Médecins Sans Frontiéres (MSF) and partners in the scale-up of HIV VL in collaboration with the Ministry of Health and Child Care (MoHCC) of Zimbabwe.Methods: A retrospective data review of routine reports from MSF-supported health facilities in Manicaland Province (Zimbabwe) was conducted. These secondary aggregate data were triangulated, and emerging themes of lessons learnt from VL monitoring were shared.Results: A VL testing coverage of 63% (5966/9456) was achieved among the 40 health facilities, together with a switch rate to second-line antiretroviral therapy (ART) of 46.4% (108/233). The key enablers to scaling-up the VL monitoring were well-equipped and supported VL laboratories, the operationalisation of the on-the-job clinical mentoring and systematic weaning off of better performing health facilities. Concerted efforts from different implementing partners and funders in the HIV programme, and close collaboration with MoHCC were pivotal.Conclusion: Our experience indicates that clinical mentoring is effective, and resulted in high VL testing coverage and up-skilling primary health care workers in VL monitoring. Attention must be focused on innovations for improving VL result utilisation, especially the identification and management of patients who fail ART.

scholarly journals Perceived Satisfaction of Public Health Facilities’ with the Quality of Logistics Service Provided by Pharmaceutical Fund and Supply Agency Bahirdar Hub, Northwest Ethiopia: Descriptive Study

2021 ◽  
Vol 4 (6) ◽  
Author(s):  
Tefera BB
Keyword(s):  
Public Health ◽  
Health Facilities ◽  
Health Centers ◽  
Sampling Frame ◽  
Arithmetic Means ◽  
Public Health Facilities ◽  
Logistics Service ◽  
Perceived Satisfaction ◽  
Logistics Services

Aim: This study aimed to investigate the satisfaction of public health facilities in the quality of logistics services received from the Pharmaceutical Fund and Supply Agency Bahirdar hub. Methodology: A descriptive research design has been used for assessing satisfaction. All hospitals in the study area were selected purposively and simple random sampling with a lottery method was used to pick health centers from the sampling frame. A total of 32 health facilities (i.e. 6 hospitals and 26 health centers) have been chosen for this research. Epidata software and SPSS version 20 were used for data entry and analysis, respectively. Frequency distribution, arithmetic means, and percentages were calculated. Result: This research discovered that 41(64.1%) of respondents were neither satisfied nor dissatisfied, while 19(29.7%) considered themselves as 'satisfied' with the overall quality of the logistics services they received. Besides, 3(4.7%) of the respondents said they were 'dissatisfied' with the service and 1(1.6%) was highly dissatisfied with the service. Conclusion: The overall perceived satisfaction of public health facilities with the quality of logistics service given by the Pharmaceutical Fund and Supply Agency Bahirdar hub was in the middle of the continuum, with the mean score close to the 5-Likert scale midpoint

Model Spasial Regionisasi dan Rujukan Fasilitas Kesehatan

2018 ◽  
Vol 1 (1) ◽  
pp. 78-86
Author(s):  
Agel Vidian Krama ◽  
Nurul Qamilah
Keyword(s):  
Health Services ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Centers ◽  
Coverage Area ◽  
Spatial Studies ◽  
Descriptive Research ◽  
Care Facilities ◽  
Health Field ◽  
Research Type

Location Hospital and Health Center in Bandar Lampung and the District Pesawaran not currently mapped by conventional or digital. And there is no data base that provides information about the location and distribution of hospitals and health centers in Bandar Lampung City, and the uneven number of health facilities to ensure the availability of health services for all citizens, by optimizing existing health care facilities. Contributions utilization of spatial studies in the health field is used for mapping and modeling of health in order to facilitate access, provision of efficiency and planning of health services in order to take policy related to determining the location of health facilities. The research method uses spatial model approach with descriptive research type and analysis through the use of Huff Model. The results of the regionization shows the coverage area of hospital services serving 33 points in the District Pesawaran and 24 point Population in Bandar Lampung with the spread of regionization is divided into 3 regions. Keywords: Health Service, Regionalization

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