scholarly journals EFFECT OF THE DISTANCES OF PUBLIC HEALTH FACILITIES FROM THE NEAREST MAJOR ROADS ON SKILLED DELIVERIES CONDUCTED IN KISUMU COUNTY, KENYA

2019 ◽  
Vol XLII-4/W14 ◽  
pp. 203-207
Author(s):  
K. Rombosia ◽  
E. Oele ◽  
N. Rangara ◽  
J. Mwaura ◽  
B. Mitto ◽  
...  
Keyword(s):  
Public Health ◽  
Linear Regression ◽  
Health Facility ◽  
Health Facilities ◽  
Major Road ◽  
Simple Linear Regression ◽  
Skilled Delivery ◽  
Public Health Facilities ◽  
Fixed Distance ◽  
The Mean

<p><strong>Abstract.</strong> The project sought to describe health facility accessibility and its effect on skilled delivery in Kisumu in line with the pillars of UHC. Proportion of skilled deliveries for 156 public health facilities conducted in 2016 was mined from DHIS2. Healthcare physical services accessibility was represented using a 5km radius fixed distance buffering around health facilities and the health facilities’ distances to the nearest major roads. Simple linear regression was then done between distances of the health facilities to their nearest major roads and skilled deliveries conducted in the health facilities. The mean skilled delivery was 42.5% (Median&amp;thinsp;=&amp;thinsp;45.8%, Range 0 to 358% and IQR&amp;thinsp;=&amp;thinsp;48.6%). There exist 4 pockets of underserved areas in Nyando, Nyakach and Muhoroni sub counties measuring 21&amp;thinsp;km<sup>2</sup>, 52&amp;thinsp;km<sup>2</sup>, 60&amp;thinsp;km<sup>2</sup>, 65&amp;thinsp;km<sup>2</sup> and 94&amp;thinsp;km<sup>2</sup> respectively. Distance from the nearest road to skilled deliveries conducted, showed the R<sup>2</sup> value was 0.02. The study found out that underserved areas are located away from major roads. The mean skilled delivery was lower than the national of 65%. However some facilities exceeded 100%. This can be explained by in referrals that cause such facilities to exceed their projected workloads. The distance of a health facility to the nearest major road is inversely proportional to the skilled deliveries conducted meaning that the further a heath facility is from a major road, lesser the skilled deliveries conducted in that facility and vice versa. However, this model is weak in establishing such an effect because of the low R<sup>2</sup> value. In conclusion, there are pockets of underserved areas in Kisumu and distance of health facilities from the nearest major road does not significantly affect the conduct of skilled deliveries in Kisumu County.</p>

scholarly journals Organizational Commitment and Associated Factors Among Health Professionals Working in Public Health Facilities of Benchsheko Zone Southwest Ethiopia

2021 ◽  
Author(s):  
Dereje Alemayehu ◽  
Shimeles Ololo ◽  
Yibeltal Siraneh
Keyword(s):  
Public Health ◽  
Organizational Commitment ◽  
Linear Regression ◽  
Leadership Styles ◽  
Health Professionals ◽  
Health Facilities ◽  
P Value ◽  
Southwest Ethiopia ◽  
Public Health Facilities ◽  
Managerial Position

Abstract Background: Organizational commitment is the relative strength of an individual’s identification with and involvement in a particular organization. It is an important predictor of absenteeism, turnover, organizational performance and success. Even though organizational commitment has a paramount importance for health care organizations, very few studies were done so far in Ethiopia particularly among health professionals. Therefore, the aim of this study was to measure level of organizational commitment and associated factors among health professionals working in public health facilities of Bench Sheko zone southwest Ethiopia. Methods: Facility based cross-sectional study was conducted in 14 Public health facilities found in randomly selected districts of Bench Sheko zone. Structured self-administered questioner was used to collect data from a total of 610 Health professionals from 10th of March – 30th of April. Data were entered into Epi-data manager Version 3.1 and exported to SPSS version 24 for further analysis. Factor analysis was done to create factor scores. Simple and multiple linear regression were done. Variables with p- value ≤ 0.25 in simple linear regression were candidate for multiple linear regression. Independent sample t-test and one-way ANOVA were done. Statistical significance was declared at p-value ≤ 0.05. Results: The response rate of the study was 96.8%. The percentages mean score of organizational commitment of health professionals’ was 74.6%. Perceived recognition of employees (B 0.806 [95% CI: 0.711 - 1.00, p=0.000], perceived conducive work climate (B: 0.421 [95%CI: .322 - 0.520], perceived transformational leadership style (B 0.749 [95%CI: .604 - .894, p=0.000], perceived transactional leadership styles (B: 0.294 [95%CI: .198 - .390 p=0.000] and not having managerial position(B:-.293 [95%CI:-.559 -0.028] were predictors of organizational commitment. Conclusion: Overall level of organization commitment of health professionals’ was higher than what is reported in many other studies. Organizational commitment was affected by job satisfaction, leadership styles and managerial position of health professionals. Hence, policy makers and human resource managers need to pay special attention to intervene on these factors.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda

2020 ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
High Rate ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment

Abstract Background: In 2018, Uganda started only 65% of persons with incident tuberculosis on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods: At ten public health facilities, laboratory register data was used to identify patients aged 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results:From January to June 2018, 510 patients (61.2% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within two weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93-13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09-3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69-11.29) and were significantly associated with pretreatment loss to follow up. Conclusion: In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

scholarly journals Estimating the effect of pretreatment loss to follow up on TB associated mortality at public health facilities in Uganda

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241611
Author(s):  
Stella Zawedde-Muyanja ◽  
Joseph Musaazi ◽  
Yukari C. Manabe ◽  
Achilles Katamba ◽  
Joaniter I. Nankabirwa ◽  
...  
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Health Facilities ◽  
Vital Status ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Tb Treatment ◽  
Health Facility Level ◽  
Facility Level

Introduction Tuberculosis (TB) mortality estimates derived only from cohorts of patients initiated on TB treatment do not consider outcomes of patients with pretreatment loss to follow-up (LFU). We aimed to assess the effect of pretreatment LFU on TB-associated mortality in the six months following TB diagnosis at public health facilities in Uganda. Methods At ten public health facilities, we retrospectively reviewed treatment data for all patients with a positive Xpert®MTB/RIF test result from January to June 2018. Pretreatment LFU was defined as not initiating TB treatment within two weeks of a positive test. We traced patients with pretreatment LFU to ascertain their vital status. We performed Kaplan Meier survival analysis to compare the cumulative incidence of mortality, six months after diagnosis among patients who did and did not experience pretreatment LFU. We also determined the health facility level estimates of TB associated mortality before and after incorporating deaths prior to treatment initiation among patients who experienced pretreatment LFU. Results Of 510 patients with positive test, 100 (19.6%) experienced pretreatment LFU. Of these, we ascertained the vital status of 49 patients. In the six months following TB diagnosis, mortality was higher among patients who experienced pretreatment LFU 48.1/1000py vs 22.9/1000py. Hazard ratio [HR] 3.18, 95% confidence interval [CI] (1.61–6.30). After incorporating deaths prior to treatment initation among patients who experienced pretreatment LFU, health facility level estimates of TB associated mortality increased from 8.4% (95% CI 6.1%-11.6%) to 10.2% (95% CI 7.7%-13.4%). Conclusion Patients with confirmed TB who experience pretreatment LFU have high mortality within the first six months. Efforts should be made to prioritise linkage to treatment for this group of patients. Deaths that occur prior to treatment initation should be included when reporting TB mortality in order to more accurately reflect the health impact of TB.

scholarly journals Patient costs for prevention of mother-to-child HIV transmission and antiretroviral therapy services in public health facilities in Zimbabwe

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256291
Author(s):  
Innocent Chingombe ◽  
Munyaradzi P. Mapingure ◽  
Shirish Balachandra ◽  
Tendayi N. Chipango ◽  
Fiona Gambanga ◽  
...  
Keyword(s):  
Public Health ◽  
Clinic Visit ◽  
Health Facilities ◽  
Adult Patients ◽  
Clear Understanding ◽  
Cross Sectional ◽  
Patient Costs ◽  
Public Health Facilities ◽  
The Mean ◽  
Mother To Child

Zimbabwe has made large strides in addressing HIV. To ensure a continued robust response, a clear understanding of costs associated with its HIV program is critical. We conducted a cross-sectional evaluation in 2017 to estimate the annual average patient cost for accessing Prevention of Mother-To-Child Transmission (PMTCT) services (through antenatal care) and Antiretroviral Treatment (ART) services in Zimbabwe. Twenty sites representing different types of public health facilities in Zimbabwe were included. Data on patient costs were collected through in-person interviews with 414 ART and 424 PMTCT adult patients and through telephone interviews with 38 ART and 47 PMTCT adult patients who had missed their last appointment. The mean and median annual patient costs were examined overall and by service type for all participants and for those who paid any cost. Potential patient costs related to time lost were calculated by multiplying the total time to access services (travel time, waiting time, and clinic visit duration) by potential earnings (US$75 per month assuming 8 hours per day and 5 days per week). Mean annual patient costs for accessing services for the participants was US$20.00 [standard deviation (SD) = US$80.42, median = US$6.00, range = US$0.00–US$12,18.00] for PMTCT and US$18.73 (SD = US$58.54, median = US$8.00, range = US$0.00–US$ 908.00) for ART patients. The mean annual direct medical costs for PMTCT and ART were US$9.78 (SD = US$78.58, median = US$0.00, range = US$0.00–US$ 90) and US$7.49 (SD = US$60.00, median = US$0.00) while mean annual direct non-medical cost for US$10.23 (SD = US$17.35, median = US$4.00) and US$11.23 (SD = US$25.22, median = US$6.00, range = US$0.00–US$ 360.00). The PMTCT and ART costs per visit based on time lost were US$3.53 (US$1.13 to US$8.69) and US$3.43 (US$1.14 to US$8.53), respectively. The mean annual patient costs per person for PMTCT and ART in this evaluation will impact household income since PMTCT and ART services in Zimbabwe are supposed to be free.

scholarly journals Outcome evaluation of capacity building and mentorship partnership (CBMP) program on data quality in the public health facilities of Amhara National Regional State, Ethiopia: a quasi-experimental evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melaku Birhanu Alemu ◽  
Asmamaw Atnafu ◽  
Tsegaye Gebremedhin ◽  
Berhanu Fikadie Endehabtu ◽  
Moges Asressie ◽  
...  
Keyword(s):  
Public Health ◽  
Data Quality ◽  
Capacity Building ◽  
Health Facility ◽  
Health Data ◽  
Outcome Evaluation ◽  
Health Facilities ◽  
The Public ◽  
Public Health Facilities ◽  
Regional State

Abstract Background Capacity Building and Mentorship Partnership (CBMP) is a flagship program designed by the Ethiopian Ministry of Health in collaboration with six local universities to strengthen the national health information system and facilitate evidence-informed decision making through various initiatives. The program was initiated in 2018. This evaluation was aimed to assess the outcome of CBMP on health data quality in the public health facilities of Amhara National Regional State, Ethiopia. Methods A matched comparison group evaluation design with a sequential explanatory mixed-method was used to evaluate the outcome of CBMP on data quality. A total of 23 health facilities from the intervention group and 17 comparison health facilities from a randomly selected district were used for this evaluation. The Organization for Economic Cooperation and Development (OECD) evaluation framework with relevance, effectiveness, and impact dimensions was used to measure the program’s outcome using the judgment parameter. The program’s average treatment effect on data quality was estimated using propensity score matching (PSM). Results The overall outcome of CBMP was found to be 90.75 %. The mean data quality in the intervention health facility was 89.06 % [95 %CI: 84.23, 93.88], which has a significant mean difference with the comparison health facilities (66.5 % [95 % CI: 57.9–75]). In addition, the CBMP increases the data quality of pilot facilities by 27.75 % points [95 %CI: 17.94, 37.58] on the nearest neighboring matching. The qualitative data also noted that there was a data quality problem in the health facility and CBMP improved the data quality gap among the intervention health facilities. Conclusions The outcome of the CBMP was highly satisfactory. The program effectively increased the data quality in the health facilities. Therefore, the finding of this evaluation can be used by policymakers, program implementers, and funding organizations to scale the program at large to improve the overall health data quality for health outcome improvement.

scholarly journals Availability, Price and Affordability of WHO Priority Maternal and Child Health Medicine in Public Health Facilities of Dessie, North-East Ethiopia

2020 ◽  
Author(s):  
Abel Demerew Hailu ◽  
Solomon Ahmed Mohammed
Keyword(s):  
Public Health ◽  
Child Health ◽  
Maternal And Child Health ◽  
Health Facilities ◽  
Public Hospitals ◽  
Price Ratio ◽  
Public Health Facilities ◽  
North East ◽  
The Mean ◽  
And Child Health

Abstract Background: Access to health care is a fundamental human right and the provision of affordable, high quality and appropriate medicines for Maternal and child health is a vital component of a well-functioning health system. The study assessed the availability, price and affordability of WHO priority maternal and child medicines in public health facilities, Dessie, North – East Ethiopia.Methods: Retrospective cross-sectional study design was conducted in Dessie town from November 2018 to February 2019. A standard checklist adapted from Logistics Indicator Assessment Tool and WHO/HAI was used to collect data on the availability, affordability, and price of 45 priority life-saving medicines from eight public health centers and two public hospitals. Descriptive statistics (percent and median) were computed for availability and prices. Affordability was reported in terms of the daily wage of the lowest-paid unskilled government worker.Results: Twenty-two medicines were not completely managed. The overall availability of WHO priority maternal and child medicines was 34.02%. The mean numbers of stock outs was 3.9 and mean number of 128.9 days. The mean average point availability was 33.5 % and 7 medicines stock out on the days of assessment. From WHO priority maternal and child medicines, 4 (40%) of the products were unaffordable and 5 (55.5%) had higher price compared to international prices. Ceftriaxone 1gm, ceftriaxone 500mg and hydralazine 20mg injection requires wages of 6.58, 8.01, and 5.02 to cover specific maternal health problems respectively. Median price ratio of priority lifesaving maternal and child medicines in public health facility ranged from 0.65 to 3.19. Conclusions: The average mean period and point mean availability was very low. The availed products were encountered with high number of stock outs and unaffordable. Strict control of inventory is recommended to have steady supply of these essential medicines and improve quality of health service. Keywords: Availability, Affordability, Price, Medicines and Maternal and child.

scholarly journals Satisfaction with Delivery Services Offered under the Free Maternal Healthcare Policy in Kenyan Public Health Facilities

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
C. M. Gitobu ◽  
P. B. Gichangi ◽  
W. O. Mwanda
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Healthcare Services ◽  
Healthcare Policy ◽  
Health Facilities ◽  
Maternal Healthcare ◽  
Healthcare Facilities ◽  
Public Health Facilities ◽  
Delivery Services ◽  
Consultation Time

Background. Patients’ satisfaction is an individual's positive assessment regarding a distinct dimension of healthcare and the perception about the quality of services offered in that health facility. Patients who are not satisfied with healthcare services in a certain health facility will bypass the facility and are unlikely to seek treatment in that facility. Objective. To determine satisfaction level of mothers with the free maternal services in selected Kenyan public health facilities after the implementation of the free maternal healthcare policy. Methods. Data was collected through a quantitative exit survey questionnaire. The respondents were mothers who had delivered in the health facilities and were waiting to leave the health facilities after discharge. The sample included 2,216 mothers in 77 public health facilities across 14 counties in Kenya under tier 3 and tier 4 categories. The number of respondents to be interviewed was proportionately arrived at based on each health facility’s bed capacity. Results. The study established a satisfaction rate of 54.5% among the beneficiaries of the free maternal healthcare services in the country. Mothers benefiting from the free delivery services were satisfied with communication by the healthcare workers, staff availability in the delivery rooms, availability of staff in the wards, and drug and supplies availability (>56%) but unsatisfied with consultation time, cleanliness, and privacy in the wards (<56%). High education levels and lengthy stay in healthcare facilities were negatively associated with the satisfaction with the free delivery services (P<0.05). Conclusion. There is a high satisfaction with the free maternal healthcare services in Kenya. However, the implementation of the free maternal healthcare policy was associated with low privacy, poor hygiene, and low consultation time in the health facilities. Therefore there is need to address these service gaps so as to attract more mothers to deliver in public health facilities.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C. Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
High Rate ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment

Abstract Background In 2018, Uganda started only 65% of persons with incident tuberculosis on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods At ten public health facilities, laboratory register data was used to identify patients aged ≥ 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results From January to June 2018, 510 patients (61.2% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within 2 weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93–13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09–3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69–11.29) and were significantly associated with pretreatment loss to follow up. Conclusion In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

scholarly journals Availability, price, and affordability of WHO priority maternal and child health medicine in public health facilities of Dessie, north-East Ethiopia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abel Demerew Hailu ◽  
Solomon Ahmed Mohammed
Keyword(s):  
Public Health ◽  
Child Health ◽  
Maternal And Child Health ◽  
Health Facilities ◽  
Public Hospitals ◽  
Price Ratio ◽  
Public Health Facilities ◽  
North East ◽  
The Mean ◽  
And Child Health

Abstract Background Access to health care is a fundamental human right, and the provision of affordable, high-quality, and appropriate medicines for maternal and child health is a vital component of a well-functioning health system. The study assessed the availability, price, and affordability of WHO priority maternal and child medicines in public health facilities, Dessie, North-East Ethiopia. Methods A retrospective cross-sectional study design was conducted in Dessie town from November 2018 to February 2019. A standard checklist adapted from the Logistics Indicator Assessment Tool and WHO/HAI was used to collecting data on the availability, affordability, and price of 45 priority life-saving medicines from eight public health centers and two public hospitals. Descriptive statistics (percent and median) were computed for availability and prices. Affordability was reported in terms of the daily wage of the lowest-paid unskilled government worker. Results Twenty-two medicines were not found at all in public health facilities. The overall availability of WHO priority maternal and child medicines was 34.02%. The mean number of stock-outs was 3.9, and the mean number was 128.9 days. The mean average point availability was 33.5%, and 7 medicines stock out on the days of assessment. From WHO priority maternal and child medicines, 4 (40%) of the products were unaffordable and 5 (55.5%) had higher prices than international prices. Ceftriaxone 1 g, ceftriaxone 500 mg, and hydralazine 20 mg injection required wages of 6.58, 8.01, and 5.02 to cover specific maternal health problems respectively. The median price ratio of priority lifesaving maternal and child medicines in public health facilities ranged from 0.65 to 3.19. Conclusions The average mean period and point mean availability was very low. The available products were encountered with a high number of stock-outs and unaffordable. The strict control of inventory is recommended to have a steady supply of these essential medicines and improve the quality of health services.

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