http://repository.iphce.org/xmlui/handle/123456789/12 2026-05-20T18:07:26Z 2026-05-20T18:07:26Z Egata, Gudina Hawulte, Behailu Mesfin, Firehiwot http://repository.iphce.org/xmlui/handle/123456789/835 2022-01-03T11:22:10Z 2020-08-31T00:00:00Z

Leadership, management and governance practices and associated factors among primary health care unit managers in selected areas of Eastern Ethiopia Egata, Gudina; Hawulte, Behailu; Mesfin, Firehiwot Background: Primary health care managers operate in an increasingly complex environment that requires updated skills and competencies. However, little is known about the strength of leadership, management and governance practices of front-line health care managers in low-income countries like Ethiopia. Identifying such practices could help strengthen health systems and improve health outcomes. Objective: To assess the strength of leadership, management and governance (LMG) practices and associated factors among primary health care managers in eastern Ethiopia. Methods: We conducted a mixed-method, cross-sectional study in four areas of eastern Ethiopia from August through September 2018. Using a multi-stage sampling technique, we selected 555 participants for the quantitative portion of the study. Twenty senior health care providers were purposively sampled for in-depth interviews. A structured pre-tested, self-administered questionnaire was used to collect quantitative data and structure interviews informed the qualitative study. Frequencies and percentages were used to summarize quantitative data. Bivariate and multivariate logistic regression analyses were conducted to assess the associations between LMG practices and predictor variables, controlling for potential confounders. Qualitative data were transcribed verbatim and analyzed thematically. Results: Slightly over half of the participants were found to engage in good management and governance practices (55% and 54.6%, respectively) and less than half demonstrated good leadership practice (48%). In multivariate logistic regression analysis, the odds of good leadership practice increased with nurses, midwives and other professionals compared with health officers. The odds of good leadership practice also increased with experience sharing with peers working at other health facilities. Experience working at another organization and sharing with peers from other facilities were significantly associated with good management practice, and having a job description was significantly associated with good governance practice. Senior health care providers perceived that managers lacked innovation and key management skills such as decision-making, time management and financial management. Although senior care providers acknowledged that there were mechanisms for holding officials accountable, they expressed concern about the potential for corruption at health facilities. Conclusion: We found that the strength of leadership, management and governance practices among the study participants was moderate. Most health care providers observed that managers lacked crucial skills that impacted organizational performance. We recommend in-service trainings, performance-oriented job descriptions and increased opportunities for managers to share with peers as strategies to improve leadership, management and governance practices in the study area, and Ethiopia more broadly.

2020-08-31T00:00:00Z Sahile, Zekariyas Yilma, Delelegn http://repository.iphce.org/xmlui/handle/123456789/834 2022-01-03T11:22:09Z 2020-08-31T00:00:00Z

Assessing effective vaccine management in West Shewa Zone, Ethiopia Sahile, Zekariyas; Yilma, Delelegn Background: Immunization is a high-impact, low-cost intervention, responsible for averting an estimated two to three million deaths each year. Despite improvements in immunization rates, children in Ethiopia do not have equal access to these services. A well-functioning immunization supply chain is crucial to reducing disparities and improving vaccination coverage. Objective: To assess the performance of the immunization supply chain in West Shewa zone, Ethiopia. Methods: We conducted a mixed-method, cross-sectional study using assessment tools designed by the World Health Organization (WHO). A total of 43 stores (1 sub-national store, 14 district stores and 28 health facilities) were randomly selected and assessed on eight performance criteria for effective vaccine management (EVM). Data were analyzed using a software developed by the WHO and EVM scores were consolidated for each store level and the entire zone. Each criterion was compared against the WHO’s recommended minimum score of 80% to evaluate the strength of the immunization supply chain. Forty-three key informants were purposively chosen to participant in the qualitative portion of the study. Interviews were transcribed, translated into English and analyzed using OpenCode software. Results: The average scores for the zone across all performance criteria ranged from 43% to 75% - below the WHO-recommended minimum standard. The West Shewa sub-national store achieved the minimum score for temperature monitoring (90%) and building, cold chain equipment and transport (82%), and the district stores achieved the minimum score for storage capacity (80%). Health facilities scored poorly in five out of the eight measures of performance compared with higher-level stores. Overall, the zonal average was highest for storage capacity (75%), temperature monitoring (74%) and vaccine management (73%), and lowest for stock management (55%), information systems and management (48%) and maintenance of building, cold chain equipment and transport (43%). Conclusion: Our study found that the immunization supply chain in West Shewa zone was poor. In-service training, computerized vaccine stock management systems and the installation of solar refrigerators may improve the immunization supply chain in this region.

2020-08-31T00:00:00Z Mekuria, Mulugeta Girma, Teka http://repository.iphce.org/xmlui/handle/123456789/833 2022-01-03T11:22:09Z 2020-08-31T00:00:00Z

Community-based health insurance coverage: Drop-out rates and associated factors among households in selected districts of West Shewa Zone, Ethiopia Mekuria, Mulugeta; Girma, Teka Background: In countries where governments are unable to subsidize health care coverage and large segments of the population cannot afford to purchase formal health insurance, community-based health insurance (CBHI) has been advanced as an alternative means of financial protection and a way to increase health care access for the poor. Objective: To examine community-based health insurance coverage, drop-out rates and associated factors among households in West Shewa zone, Ethiopia. Methods: We conducted a community-based, cross-sectional study. A multi-stage sampling technique was used to select 610 households. Data were collected using a structured questionnaire and bivariate and multivariate logistic regression analyses were employed to determine the associations between demand-side characteristics of study participants and outcome indicators of interest. Results: Thirty-three percent of the study participants had ever joined a community-based health insurance scheme, 22.1% were currently enrolled and 38% had dropped out. Sixty-nine percent of participants were willing to join a community-based health insurance scheme in the future. The main reason for dropping out was the limited benefits offered by the program. Coverage was positively associated with older age (AOR = 1.931, 95% CI = 1.225-3.044) and larger household size (AOR = 1.910, 95% CI = 1.212-3.011) and negatively associated with the absence of chronic illness in the household (AOR = 0.159, 95% CI = 0.100-0.252) and poor perceived health status of a household member with a chronic illness (AOR = 0.534, 95% CI = 0.312-0.914). Dropping out was negatively associated with the absence of chronic illness in the household (AOR = 0.266, 95% CI = 0.106-0.478). Conclusion: Our study showed that household coverage for community-based health insurance in West Shewa zone was low, with over a third of participants dropping out. We recommend that the Ethiopian Health Insurance Agency, the Federal Ministry of Health and regional and local health insurance agencies improve the benefits package to encourage greater participation. International Institute for Primary Health Care-Ethiopia

2020-08-31T00:00:00Z JSI/L10K, IIfPHC-E http://repository.iphce.org/xmlui/handle/123456789/779 2022-01-03T11:22:08Z 2020-07-07T00:00:00Z

Responsiveness to COVID-19 pandemic and its Immediate Impacts on Essential RMNCH Services in Addis Ababa: Findings of a rapid assessment JSI/L10K, IIfPHC-E

2020-07-07T00:00:00Z