卫生信息系统干预对埃塞俄比亚妇幼卫生服务利用的影响:一项准实验研究。

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Abebaw Gebeyehu Worku, Wubshet Denboba Midekssa, Hibret Alemu Tilahun, Hiwot Tadesse Belay, Zeleke Abebaw, Afrah Mohammedsanni, Naod Wendrad, Mesoud Mohammed, Shemsedin Omer Mohammed, Amanuel Biru, Benti Ejeta Futassa
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引用次数: 0

摘要

背景:卫生信息系统(HIS)在支持卫生系统管理、融资、决策和服务提供的各个方面至关重要。在埃塞俄比亚所有区域的选定工作中试点了一揽子优先卫生保健干预措施。本研究考察了卫生保健干预措施对妇幼保健服务利用的影响。方法:采用两组准实验方法进行干预对照研究。分别在2020年和2022年对两组进行了基线和终末家庭和卫生设施调查。在基线时,调查了3 016名母亲和167个保健机构。在结束时,调查了3 076名母亲和160个保健机构。本研究使用改良的常规资讯系统管理工具进行设施调查,并使用结构化问卷进行住户调查。采用混合效应模型的差中差(DID)分析来测量变化,并考虑聚类和控制可能的混杂因素。结果:干预地点在75%的关键HIS绩效指标上有较大改善。干预点90%妇幼保健服务利用指标的变化幅度较大。结论:在妇幼保健服务利用的多项指标中,干预点的变化明显高于对照点,但不具有普遍性。扩大绩效监控团队的规模至关重要,因为这是将HIS绩效与MCH服务利用率联系起来的关键途径之一。结果指标显示没有或较低的改善需要深入调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Health Information System Interventions on Maternal and Child Health Service Utilizations in Ethiopia: A Quasi-Experimental Study.

Background: Health information systems (HIS) are vital in supporting all aspects of managing health systems, financing, policymaking, and service delivery. A package of priority HIS interventions was piloted in selected woredas across all regions in Ethiopia. This study examined the impact of HIS interventions on maternal and child health (MCH) service utilization.

Methods: A 2-arm quasi-experimental study was implemented in intervention and control woredas. Baseline and endline household and health facility surveys were conducted for both arms in 2020 and 2022, respectively. At baseline, 3,016 mothers and 167 health facilities were surveyed. At endline, 3,076 mothers and 160 health facilities were surveyed. The study used modified Performance of Routine Information System Management tools for the facility survey and a structured questionnaire for the household survey. Difference-in-difference (DID) analysis using mixed effect modeling was employed to measure changes and to account for clustering and control for likely confounders.

Results: Intervention sites showed greater improvements in 75% of key HIS performance indicators. The changes in 90% of the MCH service utilization indicators were higher in the intervention sites. Significant (DID: P<.05) changes were observed in indicators including quality of antenatal care, skilled birth attendance, delivery at a health facility, family planning met need and unmet need, measles and second dose of rotavirus vaccination, and Vitamin A supplementation. BCG vaccination showed significantly higher improvement in the control sites. Other key indicators did not show significant changes.

Conclusions: In many of the MCH service utilization indicators, the changes in the intervention sites were significantly higher compared to the control sites, but it was not universal. Scale-up of performance monitoring teams is crucial because it is one of the key pathways that links HIS performance with MCH service utilization. Outcome indicators that showed no or lower improvement require in-depth investigation.

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来源期刊
Global Health: Science and Practice
Global Health: Science and Practice Medicine-Health Policy
CiteScore
3.50
自引率
7.50%
发文量
178
审稿时长
22 weeks
期刊介绍: Global Health: Science and Practice (GHSP) is a no-fee, open-access, peer-reviewed, online journal aimed to improve health practice, especially in low- and middle-income countries. Our goal is to reach those who design, implement, manage, evaluate, and otherwise support health programs. We are especially interested in advancing knowledge on practical program implementation issues, with information on what programs entail and how they are implemented. GHSP is currently indexed in PubMed, PubMed Central, POPLINE, EBSCO, SCOPUS,. the Web of Science Emerging Sources Citation Index, and the USAID Development Experience Clearinghouse (DEC). TOPICS: Issued four times a year, GHSP will include articles on all global health topics, covering diverse programming models and a wide range of cross-cutting issues that impact and support health systems. Examples include but are not limited to: Health: Addiction and harm reduction, Child Health, Communicable and Emerging Diseases, Disaster Preparedness and Response, Environmental Health, Family Planning/Reproductive Health, HIV/AIDS, Malaria, Maternal Health, Neglected Tropical Diseases, Non-Communicable Diseases/Injuries, Nutrition, Tuberculosis, Water and Sanitation. Cross-Cutting Issues: Epidemiology, Gender, Health Communication/Healthy Behavior, Health Policy and Advocacy, Health Systems, Human Resources/Training, Knowledge Management, Logistics and Supply Chain Management, Management and Governance, mHealth/eHealth/digital health, Monitoring and Evaluation, Scale Up, Youth.
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