Does health sector aid matter? Evidence from time-series data analysis in Ethiopia

Aims: Development assistance for health is an important part of financing health care in developing countries. In spite of the increasing volumes in absolute terms in development assistance for health, there are controversies on their effect on health outcomes. Therefore, this study aims to analyze the effect of development assistance for health on health status in Ethiopia. Methods: Using dynamic time series analytic approach for the period 1978-2013, this paper examines whether development assistance for health has contributed for health status change in Ethiopia. While life expectancy at birth was used as a measure of health status, vector error correction model was used for the analysis. Results: Development assistance for health expenditure (lagged one and two years) had a significant positive effect on life expectancy at birth in Ethiopia. Other things being equal, a 1% increase in per capita development assistance for health leads to 0.026 years improvement in life expectancy at birth (P<0.001) in the immediate year following the period of assistance, and 0.008 years (P=0.025) in the immediate two years following the provision of assistance. Conclusion: This study indicates that, seemingly, development assistance for health has significant favourable effect in improving health status in Ethiopia. The policy implication of this finding is development assistance for the health should continue as an interim means to an end. &nbsp

Does health sector aid matter? Evidence from time-series data analysis in Ethiopia

Aims: Development assistance for health is an important part of financing health care in developing countries. In spite of the increasing volumes in absolute terms in development assistance for health, there are controversies on their effect on health outcomes. Therefore, this study aims to analyze the effect of development assistance for health on health status in Ethiopia.Methods: Using dynamic time series analytic approach for the period 1978-2013, this paper examines whether development assistance for health has contributed for health status change in Ethiopia. While life expectancy at birth was used as a measure of health status, vector error correction model was used for the analysis.Results: Development assistance for health expenditure (lagged one and two years) had a significant positive effect on life expectancy at birth in Ethiopia. Other things being equal, a 1% increase in per capita development assistance for health leads to 0.026 years improvement in life expectancy at birth (P<0.001) in the immediate year following the period of assistance, and 0.008 years (P=0.025) in the immediate two years following the provision of assistance.Conclusion: This study indicates that, seemingly, development assistance for health has significant favourable effect in improving health status in Ethiopia. The policy implication of this finding is development assistance for the health should continue as an interim means to an end.

Wealth-based inequality in the continuum of maternal health service utilisation in 16 sub-Saharan African countries

BackgroundPersistent inequalities in coverage of maternal health services in sub-Saharan Africa (SSA), a region home to two-thirds of global maternal deaths in 2017, poses a challenge for countries to achieve the Sustainable Development Goal (SDG) targets. This study assesses wealth-based inequalities in coverage of maternal continuum of care in 16 SSA countries with the objective of informing targeted policies to ensure maternal health equity in the region.MethodsWe conducted a secondary analysis of Demographic and Health Survey (DHS) data from 16 SSA countries (Angola, Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, and Zambia). A total of 133,709 women aged 15-49 years who reported a live birth in the five years preceding the survey were included. We defined and measured completion of maternal continuum of care as having had at least one antenatal care (ANC) visit, birth in a health facility, and postnatal care (PNC) by a skilled provider within two days of birth. We used concentration index analysis to measure wealth-based inequality in maternal continuum of care and conducted decomposition analysis to estimate the contributions of sociodemographic and obstetric factors to the observed inequality.ResultsThe percentage of women who had 1) at least one ANC visit was lowest in Ethiopia (62.3%) and highest in Burundi (99.2%), 2) birth in a health facility was less than 50% in Ethiopia and Nigeria, and 3) PNC within two days was less than 50% in eight countries (Angola, Burundi, Ethiopia, Gambia, Guinea, Malawi, Nigeria, and Tanzania). Completion of maternal continuum of care was highest in South Africa (81.4%) and below 50% in nine of the 16 countries (Angola, Burundi, Ethiopia, Guinea, Malawi, Mali, Nigeria, Tanzania, and Uganda), the lowest being in Ethiopia (12.5%). There was pro-rich wealth-based inequality in maternal continuum of care in all 16 countries, the lowest in South Africa and Liberia (concentration index = 0.04) and the highest in Nigeria (concentration index = 0.34). Our decomposition analysis showed that in 15 of the 16 countries, wealth index was the largest contributor to inequality in primary maternal continuum of care. In Malawi, geographical region was the largest contributor.ConclusionsAddressing the coverage gap in maternal continuum of care in SSA using multidimensional and people-centred approaches remains a key strategy needed to realise the SDG3. The pro-rich wealth-based inequalities observed show that bespoke pro-poor or population-wide approaches are needed

Does health sector aid matter? Evidence from time-series data analysis in Ethiopia

Aims: Development assistance for health is an important part of financing health care in developing countries. In spite of the increasing volumes in absolute terms in development assistance for health, there are controversies on their effect on health outcomes. Therefore, this study aims to analyze the effect of development assistance for health on health status in Ethiopia. Methods: Using dynamic time series analytic approach for the period 1978-2013, this paper examines whether development assistance for health has contributed for health status change in Ethiopia. While life expectancy at birth was used as a measure of health status, vector error correction model was used for the analysis. Results: Development assistance for health expenditure (lagged one and two years) had a significant positive effect on life expectancy at birth in Ethiopia. Other things being equal, a 1% increase in per capita development assistance for health leads to 0.026 years improvement in life expectancy at birth (P<0.001) in the immediate year following the period of assistance, and 0.008 years (P=0.025) in the immediate two years following the provision of assistance. Conclusion: This study indicates that, seemingly, development assistance for health has significant favourable effect in improving health status in Ethiopia. The policy implication of this finding is development assistance for the health should continue as an interim means to an end

Enrollment in community based health insurance program and the associated factors among households in Boricha district, Sidama Zone, Southern Ethiopia; a cross-sectional study.

BACKGROUND:In absence of any form of health insurance, out-of-pocket payments for health care lead to decreased use of health services and catastrophic health expenditures. Community-based health insurances has been promised financial model for informal sectors to reduce these problems in many countries. When this comes down to Ethiopia, in the South Nation Nationality People's Region of the country established 52 schemes including Boricha district, the study area However, there has been little evidence about the enrollment status and the associated factors in the study area in particular elsewhere in general. OBJECTIVE:The study aims to assess the current enrollment status of households in community based health insurance and the associated factors in Boricha district of Sidama Zone, Southern Ethiopia. METHODS AND MATERIALS:A community based cross-sectional study design was employed from February 01, 2019 to March 31, 2019, using a sample of 632 households. Data were collected using interviewer-administered pre-tested questionnaire and entered into EPI-Info 7and transported to SPSSversion20 for analysis. Multi-variable logistic regression analysis along with odds ratio and the corresponding 95% CI was conducted and significance was declared at P-value <0.05. RESULTS:Current enrollment status of households in community based health insurance was found to be 81 (12.8%). According to this study, educational status; secondary school& above[AOR = 2.749, 95%CI(1.142, 6.618)], timing of collecting premium [AOR = 0.433; 95% CI (0.196, 0.958)], family size ≥5, [AOR = 4.16;95%CI (1.337, 12.944)], no trust on scheme management[AOR = 0.272; 95%CI (0.140, 0.528)], lack of information [AOR = 0.086; 95%CI (0.026, 0.288)], dissatisfaction with health care service received[AOR = 0.303; 95%CI (0.171, 0.537)], no chronic illness in the family[AOR = 0.259; 95%C.I.(0.137, 0.488)] were factors significantly associated with current enrollment status in CBHI. CONCLUSIONS:Households head's education status, timing of premium collection, family size, no trust on scheme management, lack of information, services dissatisfaction and chronic illness in the family member were the identified factors associated with enrollment in CBHI in the study area. Therefore, to enhance the enrollment and sustainability of CBHI in the study area awareness creation, improving timing of premium collection, strengthening scheme management, improving quality of service are the areas that decision makers needs to intervene

Factors associated with the length of stay in emergency departments in Southern-Ethiopia

Abstract Objectives This cross-sectional study was conducted on 399 patients at Hawassa University Comprehensive Specialized Hospital from February 15 to March 30/2018 to assess the length of stay (LOS) and its associated factors in emergency departments (EDs). Result About 91.5% patients were stayed in the EDs for greater than 24 h in different reasons. Inadequacy of beds in inpatient wards, overcrowding, absence of different laboratory test profiles and delay in radiological services were showed a significant differences in LOS greater than 24 h when compared to LOS ≤ 24 h in EDs (p < 0.05 for all). In addition, admission beds [adjusted odds ratio: 8.7 (95% CI 3.2–23.2)]; overcrowding [adjusted odds ratio: 3.6 (95% CI 1.6–8.3)]; laboratory test profiles [adjusted odds ratio: 5.1 (95% CI 1.9–14.1)], and radiology services [adjusted odds ratio: 3.7 (95% CI 1.5–9.2)] were significantly and positively associated with LOS greater than 24 h in EDs. Further, a significant proportion of patients were stayed for unnecessary extended length of time in EDs due to different factors. Therefore, the commitment of organization is crucial to provide sufficient number of admission beds, to scale-up laboratory test profiles and to decrease radiology service turn-around time in order to improve LOS in EDs

Frailty status and associated factors among older PLHIV in Southern Ethiopia

Background Studies addressing frailty are limited in the global south, including Ethiopia. We estimated the prevalence of frailty and associated factors among older people living with HIV (PLHIV) attending a large Comprehensive Specialized Hospital in southern Ethiopia. Methods A systematic sample of 187 PLHIV and 187 HIV-negative controls > 50 years old were recruited between October 1 and November 30, 2021. Data on socio-demographic, behavioural and clinical characteristics were collected using a structured questionnaire. Frailty assessments were completed using the brief frailty instrument (B-FIT-2), which consists of 6 components. Scoring 5–6 points was frail, 2–4 points were pre-frail and below 2 was considered as non-frail. Logistic regression model was used to measure association between variables. Results Median (IQR) age was 53 (50, 80) for PLWH and 59 (55–66) for controls. Prevalence of frailty was 9.1% for PLHIV Versus 5.9% for controls. A significant proportion of PLHIV was pre-frail; 141 (75.4%) compared to controls 110 (58.8%). Pre-frailty status was associated with HIV diagnosis (adjusted odds ratio (aOR) 4.2; 95% CI 1.8–9.9), low age (aOR 0.3; 95% CI 0.1–0.6), lower educational attainment (aOR 2.2; 95% CI 1.0–4.9), being farmer (aOR 3.2; 95% CI 1.0–10.2) and having high or low body mass index (BMI) (aOR 11.3; 95% CI 4.0–25.8). HIV diagnosis (aOR 9.7; 95% CI 1.6–56.8), age (aOR 0.2; 95% CI 0.1–0.7), lower educational attainment (aOR 5.2; 95% CI 1.5–18.2), single status (aOR 4.2; 95% CI 1.3–13.6), farmer (aOR 19.5; 95% CI 3.5–109.1) and high or low BMI (aOR 47.3; 95% CI 13.8–161.9) predicted frailty. Conclusion A high proportion of frailty and pre-frailty was observed in a cohort of older PLHIV attending care in Southern Ethiopia. Future research should focus on interventions targeting factors associated with frailty