Abstract
BackgroundPrimary health care (PHC) in Ethiopia serves as the main entry point for preventive, promotive and curative health services. The district health office is responsible for the planning, implementation and evaluation of all district health activities. In addition, district health offices manage service delivery facilities working on provision of PHC – primary hospitals, health centers and health posts. As the leader of the health care system tier, district health management must ensure direction, alignment and commitment within teams and organizations and make sure that achievements are consistent with the vision, values and strategy of the organization. USAID Transform: Primary Health Care provides diverse support to improve district health manager competencies including in-service trainings followed by planning and implementation of performance improvement projects and on-the-job mentoring and support.MethodsThis study was conducted to compare district level capacity and performances between leadership, management and governance (LMG) and non-LMG districts. Project outcome monitoring data that shows the performance of districts was collected from 284 districts from January to December 2019. The study was carried out using a comparative-cross sectional study design, which assessed and compared district health office level indicators. Districts were classified into two categories: LMG and non-LMG districts. The study compared data from 94 LMG and 190 non-LMG districts. Propensity score matching was used to control the effect of differences between LMG and non-LMG districts.ResultsResults of the independent samples t-test revealed that LMG districts scored better average performances of 61.8 ± 121.45 standard deviation (SD) compared to non-LMG districts 56.89 ± 110.39 SD, with t (282243) = − 3.407317 and p < 0.001, two-tailed. The difference of 4.9 percentage unit in the average performance indicated a statistically significant difference between the LMG and non-LMG districts.ConclusionDistrict level leadership development program contributes to improving district capacity, structure and management practices, and quality of care.
Highlights
Primary health care in Ethiopia serves as the main entry point for preventive, promotive and curative health services
This study revealed that implementation of LMG training followed by supervision and monitoring resulted in improved implementation of LMG related functions, improved capabilities and initiated a sense of positive competition among health facilities to achieve planned facility-level service delivery objectives [9]
District health offices are a critical structure to ensure the proper delivery of primary health care at the lower levels of the health system in Ethiopia
Summary
Primary health care (PHC) in Ethiopia serves as the main entry point for preventive, promotive and curative health services. District health offices manage service delivery facilities working on provision of PHC – primary hospitals, health centers and health posts. The government of Ethiopia has long been implementing the principle of primary health care in the country. Primary health care in Ethiopia serves as the main entry point for preventive, promotive and curative health services. District health offices manage service delivery facilities under PHC – primary hospitals, health centers and health posts. Availability and effective use of resources, appropriate planning and management of primary care is important for quality, cost-effective and equitable health service delivery. Trained and motivated health workforce including managers are vital to appropriate functionality of PHC [3]
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