Search

Background Using reliable evidence from routine health information system (RHIS) over time is a vital aid to improve health outcome, tackling disparities, enhancing efficiency, and encouraging innovation. In Ethiopia, utilization of routine health data for improving the performance and quality of care was not well-studied in grassroot health facilities. Objective This study was conducted to determine the level of RHIS utilization and associated factors among health professionals in public health facilities of Dire Dawa, eastern Ethiopia. Methods An institution-based cross-sectional study was conducted among 378 health professionals from June 10 to July 20, 2020. Self-administered pretested-structured questionnaire was used to collect data from the participants. Data were entered using EpiData 3.1 and analyzed using Stata 16.0. Descriptive statistics was used to describe the basic characteristics of the participants, and multivariable logistic regression analysis was conducted to identify factors associated with RHIS utilization. Adjusted odds ratio (AOR) (95% CI) was used to report association and significance declared at a P- value

BackgroundThe electronic community health information system (eCHIS) has been implemented in Ethiopia to support health services delivered by community health workers. Despite the many benefits of digitizing community health information systems, the implementation of the eCHIS is challenged by many barriers resulting in low uptake. This study assessed the barriers, facilitators, and motivators of eCHIS use among health workers with focus on health extension workers (HEWs) in Ethiopia.MethodsPhenomenological approach was used to assess the barriers, facilitators and motivators of eCHIS use in Amhara, Harari, Oromia, Sidama, South West Ethiopia and Southern Nation Nationalities and People's regions of Ethiopia. Data were collected from 15–29 May 2022. A total of 54 face-to-face in-depth interviews were conducted among HEWs, HEW supervisors, health information technicians and managers. The interviews were audiotaped using Open Data Kit, transcribed verbatim and translated into English. OpenCode 4.03 software was used for coding and categorizing the data. Thematic analysis was used to analyze the data.ResultsThe HEWs and other eCHIS users reported lack of infrastructure and resources; poor quality of training, follow-up, and supervision; parallel recording using the manual and electronic system; and HEWs' workload as barriers hindering eCHIS use. Data quality, retrievability, and traceability; tablet portability; encouragement from supervisors; and positive image in the community resulting from HEWs using tablets in their routine activities were the main facilitators of eCHIS use.ConclusionThe study identified various barriers that adversely affect the use of eCHIS. An integrated and coordinated approach to eCHIS implementation that encompasses removing the barriers, and reinforcing facilitators is required.

Summary: Background: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval [UI] 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. Funding: Bill & Melinda Gates Foundation.

BackgroundMaternal mortality has remained an international public health problem although it is decreasing in recent years. Developing countries particularly Sub-Saharan African countries bears the high burden of maternal deaths. There was no study conducted to assess prevalence and associated factors of home delivery among women in Ethiopia on antenatal care (ANC) follow up nationally. Therefore, this study was conducted to assess the magnitude and associated factors of home delivery in Ethiopia.ObjectivesTo assess the magnitude of home delivery and associated factors among women who had ANC follow up in Ethiopia.MethodsSecondary data analysis was carried out using Ethiopian Mini Demography and Health Survey (EMDHS 2019). A total weighted sample of 2,143 women who had ANC follow up during pregnancy was incorporated in the study. In a generalized linear mixed model (GLMM), Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) and p < 0.05 were declared as associated factors of home delivery.ResultsThe prevalence of home delivery was 31.27% [95% CI: 29.34%, 33.27%] among women who had ANC follow up in Ethiopia. Attended higher education [AOR = 0.27; 95% CI: (0.13, 0.54)], rural resident [AOR = 2.15; 95% CI: (1.19, 3.90)], richest in the wealth index [AOR = 0.18; 95% CI: (0.10, 0.32)], had adequate ANC follow up [AOR = 0.25; 95% CI: (0.13, 0.51)] and being in third trimesters [AOR = 0.64; 95% CI: (0.49, 0.83)] during first ANC visit were significantly associated factors of home delivery.ConclusionNear to one-third of women in Ethiopia have delivered their babies at home even if they had an ANC follow up. Educational status, place of residence, wealth index, timing of first antenatal check and adequate ANC visit has shown significant association with home delivery. Therefore, focused intervention packages need to be implemented at all levels of the health care system in Ethiopia to improve health seeking behaviors of women who have ANC follow up to have delivery in health care institutions. While doing so, special attention should be given for poor, uneducated and rural dweller women.

BackgroundIn Ethiopia, the magnitude of antenatal care (ANC) practice and institutional delivery is low as compared with developed countries. The majority of the pregnant women have not completed their ANC follow-up and only 43% of women have reached the four and above ANC. This study was conducted to determine the magnitude of ANC dropout and associated factors among pregnant women in Ethiopia.MethodsSecondary data analysis was conducted using the 2019 Ethiopia Mini Demographic and Health Survey 2019 (2019 EMDHS). The sample was selected using a stratified, two-stage cluster sampling design and the data were analyzed using the binary logistic regression model to identify factors associated with ANC dropout. Adjusted odds ratio (AOR) with 95% CI was reported to declare significance and strength of association. A total weighted sample of 2,143 women who had antenatal care follow-up during pregnancy was included. In the multivariate logistic regression analysis, variables having a p-value < 0.05 were considered to have a significant association with ANC dropout.ResultThe magnitude of ANC dropout was 39.12% (95% CI: 37.07 and 41.20%) among women who had ANC follow-up in Ethiopia. Aged 30–49 years [AOR = 0.71; 95% CI: (0.54, 0.94)], attended primary [AOR = 0.79; 95% CI: (0.62, 0.99)], secondary [AOR = 0.63; 95% CI: (0.44, 0.87)], and higher education [AOR = 0.39; 95% CI: (0.25, 0.62)], were in first trimesters [AOR = 0.49; 95% CI: (0.40, 0.60)] at the time of first ANC visit, and had access to laboratory service [AOR = 0.25; 95% CI: (0.13, 0.51)] were found to be a negative significant associated factors of ANC dropouts, whereas being rural resident [AOR = 1.53; 95% CI: (1.11, 2.10)] has a positive significant association with ANC dropouts.ConclusionMore than one-third of the pregnant women in Ethiopia had dropped out from their ANC follow-up in the study period. Being old-aged, educated, urban resident, having a first ANC visit in the first trimester, and having access to laboratory service were negatively associated with ANC dropouts. Therefore, we recommended encouraging women to have ANC visit at an early stage of pregnancy and conducting basic laboratory investigations during their visit. When undertaking that, due attention should be given to young, uneducated, and rural dweller women.

Background: The electronic medical record system is a crucial tool for facilitating health care improvement in quality patient care, patient safety, and cost reduction by providing easy access to medical data. However, healthcare experts' limited adoption comes with considerable caution to ensure effective implementation. The goal of this study was to identify the major obstacles to the acceptance of the electronic medical record system from the perspective of physicians and nurses. Methods: A Scoping review was performed by scientific works of literature available in Pubmed, Scopus, ProQuest, ScienceDirect, and Google Scholar from 2011 to 2020, concerning the obstacles to EMR system acceptance. Results: The scoping review included Twenty-one studies that considered obstructions to the execution of the electronic medical record system by healthcare experts. Seven types of obstacles have been identified: i. Technical ii. Financial iii. Time iv. Legal v. Organizational vi. Psychological, and vii. Social. The most frequently mentioned obstacles were technical, financial, time, and legal. In addition, organizational, psychological, and social obstructions were also identified. Conclusion: The evidence provided by this study may be used as an outline of the obstacles that health experts might meet within the EMR system implementation procedure. It may be important to EMR policymakers and facilitators on its own. Also, the survey demonstrates policymakers have to further awareness of the truth that removing technological, financial, time and legal obstacles is not sufficient to ensure the implementation of the system.

Background: The number of studies on the magnitude of anemia and its determinant factors among lactating mothers is limited in East African countries regardless of its multivariate consequences. Even though few studies were conducted on the magnitude of anemia and its determinants, most of them focused on the country level and different parts of countries. Therefore, the current study is aimed to determine the magnitude of anemia and determinant factors among lactating mothers in East African countries.Methods: From nine East African countries, a total weighted sample of 25,425 lactating mothers was included in the study. Determinate factors of anemia were identified using generalized linear mixed models (GLMM). Variables with a p < 0.05 in the final GLMM model were stated to confirm significant association with anemia.Result: The magnitude of anemia in East African countries was found to be 36.5% [95% confidence interval (CI): 35.55%, 36.75%]. Besides, as for the generalized linear mixed-effect model, age, educational status, working status, country of residence, wealth index, antenatal care service, place of delivery, history of using family planning in a health facility, current pregnancy, and visited by fieldworker in the last 12 months were factors that have a significant association with anemia in lactating mothers.Conclusion: In East Africa, more than one-third of lactating mothers have anemia. The odds of anemia were significantly low among young mothers (15–34), who had primary education, were working, country of residence, and higher wealth index (middle and high). In addition, the likelihood of anemia was also low among lactating mothers who had antenatal care, used family planning, delivered at a health facility, were pregnant during the survey, and visited by fieldworkers. Therefore, promoting maternal care services (family planning, Antenatal Care (ANC), and delivery at health facilities) and a field visit by health extension workers are strongly recommended.