The Ethiopian Journal of Health Development

Factors Inhibiting and Enabling Performance-Based Financing in Health Care Delivery across Low and Middle-Income Countries: A Scoping Review

Mideksa Adugna, Girmaye Dinsa, Nelisiwe Khuzwayo — Thu, 14 Mar 2024 00:00:00 -0400

Abstract
Background: Emerging financing strategies in the health sector have been developed to improve the impact of investments and enhance healthcare outcomes. One promising approach is Results-based Financing, which establishes a connection between financial incentives and pre-established performance targets. This innovative approach holds the potential to strengthen healthcare delivery and strengthen overall healthcare systems.
Aim: The scoping review endeavored to systematically delineate the body of evidence pertaining to facilitators and barriers to the implementation of performance-based financing within the realm of healthcare provision in low- and middle-income nations.
Methods: The review used Preferred Reporting Items for Systematic Reviews and a Meta-Analysis extension for Scoping Reviews checklist to select, appraise, and report the findings. We searched PubMed, Web of Science, and Google Scholar databases and grey literature published between January 2000 and March 2022. We conducted the abstract screening with two independent reviewers. We also performed full-article screening. We used the six methodological frameworks proposed by Arksey and O'Malley. The results were thematically analyzed.
Results: Of the 1071 searched studies, 34 met the eligibility criteria. 41% of the studies were descriptive, 26% cross-sectional, 18% trial, and 15% cohort studies. The enabling and inhibiting factors of performance-based financing in healthcare delivery have been identified. Moreover, the review revealed that performance-based financing's influence on service delivery is context-specific.
Conclusion: The facilitators and impediments to the effectiveness of performance-based financing in enhancing service delivery are contingent upon a holistic comprehension of the contextual factors, meticulous design, and efficient execution. Factors such as the level of care facilities, presence of community-based initiatives, stakeholder involvement, and participatory design emerge as key facilitators. Conversely, barriers such as communication obstacles, inadequacies in the PBF models, and deficiencies in the healthcare workforce are recognized as inhibitors. By harnessing the insights derived from a multitude of evidence incorporated in this scrutiny, stakeholders can deftly navigate the intricacies of performance-based financing, while also considering the prospective areas for further exploration and research.. [Ethiop. J. Health Dev. 2024; 38(1): 00-00]
Keywords: Performance-based financing, healthcare delivery, Scoping review.
Registration: The scoping review protocol was not registered

Association of Harsh Physical Disciplining and the Mental and Behavioral Health Problems among Pre-School Children in Ethiopia

Yonas Baheretibeb — Thu, 07 Mar 2024 00:00:00 -0500

Abstract Background: Harsh physical discipline may have an impact on the emotional and behavioral health and cognitive abilities of children and adolescents. There is little understanding of the association between harsh physical disci-pline and mental health issues in populations where harsh disciplinary measures are culturally normal.
Objective: The primary objective of this research was to investigate the potential correlation between the use of harsh physical discipline methods and the development of mental and behavioral health issues in children. By ex-amining the impact of these disciplinary practices on the psychological well-being of children, this study sought to shed light on the potential long-term consequences of such parenting strategies. Through a thorough analysis of data collected from a diverse sample of families, the researchers aimed to provide valuable insights into the effects of harsh physical disciplining on child mental health outcomes. Methods: A cross-section survey was conducted on 358 pre-school children preschool children and their primary caregivers in ten randomly selected elementary schools in Addis Ababa. The Strengths and Difficulties (SDQ) questionnaire was used to measure the mental and behavioral health of the children. The Parent-Child Conflict Tactics Scale measured the primary caregivers' experience of harsh physical discipline.
Result: The study found that more than two of the three primary caregivers witnessed the harsh physical discipline of pre-school children in their lifetime. The study also showed that the likelihood of having any of the mental or behavioral problems was higher among children who experienced harsh physical discipline. AOR = 5.8; 95% CI, 1.7, 17.4). It was also higher among preschool children in the second (AOR = 2.9; 95% CI, (1.2, 7.0)) order of birth and children perceived to have a moderate AOR = 5.0; 95% CI, (1.1, 23.4) and a lower AOR = 17.0; 95% CI, 17.0 (1.3, 218) school performance.
Conclusion This study has revealed a concerning connection between the physical discipline of preschool-aged children and the development of mental and behavioral health issues. The findings underscore the importance of policymakers and stakeholders in implementing interventions to prevent harsh verbal and physical discipline of young children. Society as a whole must prioritize the well-being and emotional health of our youngest members, and taking steps to promote positive and nurturing forms of discipline is essential in safeguarding their overall development and future success. [Ethiop. J. Health Dev. 2024; 38(1): 00-00]
Keywords: Physical discipline, mental/ behavioral health problem, preschool children

Quality of Antenatal Care as a Means of Safeguard for Low Birth Weight: A Longitudinal Study in Hadiya Zone Centeral Ethiopia regional state Ethiopia.

Fri, 29 Mar 2024 00:00:00 -0400

Abstract
Background: A child's birth weight is an important indicator of a child's vulnerability to the risk of childhood illness and the chances of survival. Quality antenatal care is expected to improve the birth weight. The main aim of this study was to determine the effect of quality antenatal care on birth weight.
Method: A facility-based prospective follow-up study design was conducted among 859 mothers with gestational age ? 16 weeks. The pregnant mothers who came for their first antenatal visit were recruited and followed until the delivery time. A standardized observational checklist was adopted and adapted to collect the longitudinal data. During the first visit, data on socio-demographic, obstetric, and medical history was collected using an interview-administered questionnaire, and during delivery weight of the baby was taken. Quality antenatal care service was considered to be good, provided that mothers received 75% of the essential component of the ANC services. General estimating equation logistic regression analysis was done to determine the effect of quality antenatal care on low birth weight.
Result: A total of 859 babies were included in this analysis, resulting in a response rate of 100%. The incidence of low birth weight was 17.9% (95% CI: 15.5% ?20.6%). Good quality of ANC services was strongly associated with reduced risk of having LBW by 98% (AOR=0.020 (95%CI =0.005, 0.054). In addition, the risk of having a low birth weight baby was higher among mothers who had a history of abortion, premature delivery, and monthly income.
Conclusion: The study highlights a high incidence of low birth weight in the study area, emphasizing the urgency for stakeholders to take decisive action to address this problem. Increasing the quality of Antenatal Care (ANC) services emerges as a pivotal strategy in mitigating the risk of low birth weight. Federal Ministry of Health and other partners working in the area should promptly design and implement effective strategies to enhance the standards of ANC services, aiming for a significant reduction in the incidence of low birth weight within the community. [Ethiop. J. Health Dev. 2024; 38(1): 00-00]
Keyword: Antenatal care, Ethiopia, Hossana,Longitudinal, Low birth weight, Quality

Sustainability of Malaria Prevention Strategies in Uganda and Zimbabwe: A Systematic Review

Wed, 06 Mar 2024 00:00:00 -0500

Abstract
Background- Malaria is a parasitic infectious disease spread through the bite of an infected female Anopheles mosquito. Presently two vector control strategies play a pivotal role in the control of malaria – Indoor Residual Spraying and treated bed nets.
Preventive and control measures have been put in place in Zimbabwe and Uganda to eliminate this menace. However, the efforts are proving futile as the number of cases continues to increase annually.
Objective- The review was aimed at determining the ability of indoor residual spraying and long-lasting insecticidal nets to continue achieving malaria elimination over time in Zimbabwe and Uganda.
Methods- A systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search based on Patient, Intervention, Comparison, and Outcomes was used on the Web of Science, EBSCO host and Science Direct databases for the best relevant results. Thirty-six full-text articles were passed to the systematic review. Factors that were evaluated include vector resistance to insecticides, the reported extent of community involvement, sustainability prospects, and the impact of indoor residual spraying and long-lasting insecticidal nets in malaria elimination.
Results- The available literature suggests that the sustainability of malaria control initiatives in Uganda and Zimbabwe may be unachievable. There seems to be a gap in all the reviewed literature concerning the assessment of the level of participation of the communities in which these strategies are being implemented. The communities are mere recipients of the control measures without adequate involvement. Hence, their sustainability is not being realized.
Conclusion- Zimbabwe and Uganda may continue to face challenges in the fight against malaria if they do not incorporate sustainability concepts into their malaria elimination efforts. Their continued overreliance on international aid and Non-Governmental Organizations will remain their major pitfall. [Ethiop. J. Health Dev. 2024; 38(1): 00-00] Keywords Sustainability; Malaria elimination; Malaria vector control; Indoor Residual Spraying; Long Lasting Insecticidal Nets.