Healthcare Services In sub-Saharan Africa Research Articles

Assessment of Barriers to Access and Utilization of Reproductive and Child Healthcare Services in Sub-Saharan Africa: A Review

The new Sustainable Development Goals (SDG3) for 2030 aim to promote excellent health and well-being, as well as reduce mother and infant mortality, by ensuring equal access to reproductive and child healthcare services. Compromises in access to reproductive and child healthcare services in SubSaharan Africa contribute to a rise in maternal and newborn mortality. A desk study was conducted to look into barriers to access and utilization of reproductive and child healthcare services in Sub-Saharan Africa, from the perspectives of both community people and health workers. According to the findings, the most significant hurdles to access and usage of reproductive and child healthcare services are transportation barriers to health facilities, economic considerations, and cultural views, as well as a lack of family support and poor care quality. More study is needed to aid policymakers in taking multi-sectoral action to provide equitable access to reproductive and child healthcare services in line with SDG3 by 2030.

Efficiency and productivity analysis of maternal and infant healthcare services in Sub-Saharan Africa.

The paper examines the efficiency and productivity of Sub-Saharan African (SSA) countries towards maternal and infant healthcare services between 2015 and 2019. Data envelopment analysis is utilised to evaluate efficiency, and Malmquist-Luenberger's (ML) productivity estimation is employed for productivity analysis. The results indicate inefficiency in SSA maternal and infant healthcare services. Average efficiency is pegged at 85%, and 60% of the countries evaluated had below-average efficiency. Effects of socioeconomic dynamics of countries were analysed. Preliminary estimations on the impact of Gross domestic product (GDP), education, urban population, and total population on efficiency are not significant. Although GDP and education sometimes show that they influence efficiency positively. Sensitivity analysis indicates efficiency to be more responsive to health expenditure, as well as to nurses and midwives. ML Productivity decomposition into technical efficiency change and technological change indicates improvement in technical efficiency as the principal driver of efficiency and productivity. Policy recommendations are made in line with the findings, requirements, and constraints of SSA countries.

Stated Preference Research in Reproductive and Maternal Healthcare Services in Sub-Saharan Africa: A Systematic Review

Understanding the preferred choice of healthcare service attributes for women is important, particularly in sub-Saharan Africa where resources are constrained and improving reproductive and maternal healthcare services is of high importance. The aim of this systematic review was to identify attributes of reproductive and maternal healthcare services in sub-Saharan Africa, and summarise the factors shaping women's preference to access these services. PubMed/MEDLINE, EMBASE, PsycINFO and CINAHL were searched from the inception of each database until March 2021 for published studies reporting stated preferences for maternal and reproductive healthcare services in sub-Saharan Africa. Data were extracted using a predefined extraction sheet, and the quality of reporting of included studies was assessed using PREFS and ISPOR (International Society for Pharmacoeconomics and Outcomes Research) checklists. The Donabedian's model for quality of healthcare was used to categorise attributes into "structure", "process" and "outcome". A total of 13 studies (12 discrete choice experiments and one best-worst scaling study) were included. Attributes related to the structure of healthcare services (e.g. availability of technical equipment, medications or diagnostic facilities, having good system conditions) are often included within the studies, and are considered the most important by women. Of the three dimensions of quality of healthcare, the outcome dimension was the least frequently studied across studies. All except one study explored women's preferences and the participants were pregnant women, women aged 18-49 years who had recently given birth and women living with human immunodeficiency virus. The included studies came from five sub-Saharan Africa countries of which Ethiopia and South Africa each contributed three studies. All of the included studies reported on the purpose, findings and significance of the study. However, none of the studies reported on the differences between responders vs non-responders. Nine of the 13 studies employed the ISPOR checklist and reported each item including the research question and the methods for identifying and selecting attributes, and provided the findings in sufficient detail and clarity. Aligning maternal healthcare service provision with women's preferences may foster client-oriented services and thereby improve service uptake and better patient outcomes.

A Qualitative Study to Explore the Experiences of Older People Utilising Outpatient Healthcare Services from a Teaching Hospital in Ghana.

Background Empirical evidence suggests that when older people are provided with quality and affordable healthcare services, their health status can be improved. However, in low- and middle-income countries, healthcare services may not be fully resourced, leading to difficulties for older people utilising those services. There is a paucity of research studies regarding the experiences of older persons accessing healthcare services in sub-Saharan Africa including Ghana. Aim The purpose of this study was to explore and describe the experiences of older people utilising outpatient healthcare services from a Teaching hospital in Ghana. Methods This study adopted a descriptive qualitative approach to describe the experiences of older persons utilising outpatient healthcare services. Participants included a total of twelve older people between the ages of 60 and 80 years who utilised outpatient healthcare services at the hospital. A semistructured interview guide was used to conduct interviews with participants, and their views were analysed into descriptive themes. Results The results in this study showed that the participants experienced the following in utilising outpatient healthcare services: long waiting hours in accessing outpatient healthcare, poor attitudes from health staff, lack of drugs from the healthcare facility, inadequate information from health staff in the healthcare facility, lack of specialist care at the healthcare facility, and high confidence and trust in the efficacy of the orthodox healthcare. Conclusion The findings from this qualitative study demonstrated that the participants encountered some challenges in accessing outpatient healthcare services. There is the need for government and other stakeholders to address the challenges encountered by older people in accessing healthcare in order to facilitate the utilisation of healthcare among older persons for better health outcomes.

Determinants of Women Access to Healthcare Services in Sub-Saharan Africa

Background: The study examined the socio-economic determinants of women access to healthcare services in Sub-Saharan Africa for the period 1995-2015. Methods: The study adopted the dynamic panel model and estimated it using the System Generalized Method of Moments in a bid to overcome the endogeneity problem inherent in the model of study. Result: The study harmonized the theoretical strands in the literature by describing the measure of access determinants as three main components; i. Health service availability, ii. Health service utilization and iii. Health service decision. Conclusion: The indicators of health service availability such as community health workers, physicians, nurses and midwives and hospital beds improve women's access to healthcare facilities in Africa. Also, health service utilization indicators such as population density worsen the quality of healthcare services available to women while electricity access and private health expenditure enhance women’s access to quality healthcare delivery. Health service decision indicators such as female bank account ownership, female labour force participation, attainment of basic education and female household headship were important in enhancing women's access to healthcare facilities. Generally, women's health outcomes were more responsive to health service utilization; implying that service utilization is an important proof of healthcare access in Africa.

Socio-demographic Determinants of Utilization of Maternal Healthcare Services in Sub-saharan Africa: A Brief Review

Socio-demographic Determinants of Utilization of Maternal Healthcare Services in Sub-saharan Africa: A Brief Review

Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa

BackgroundIn Africa, health research on indigent people has focused on how to target them for services, but little research has been conducted to identify the social groups that compose indigence....

Socio-economic Determinants of Women Access to Healthcare Services in Sub-Saharan Africa

The study examined the socio-economic determinants of women access to healthcare services in Sub-Saharan Africa for the period 1995-2015. The study adopted the dynamic panel model and estimated it using the System Generalized Method of Moments in a bid to overcome the endogeneity problem inherent in the model of study. The study harmonized the theoretical strands in literature by describing the measure of access determinants as three main components: i. health service availability, ii. Health service utilization and, iii. Health service decision. The indicators of health service availability such as community health workers, physician, nurses and midwives and hospital beds improve women access to healthcare facilities in Africa. Also, health service utilization indicators such as population density worsen the quality of healthcare services available to women while electricity access and private health expenditure enhances women access to quality healthcare delivery. Health service decision indicators such as female bank account ownership, female labour force participation, attainment of basic education and female household headship were important in enhancing women access to healthcare facilities. Generally, women health outcomes were more responsive to health service utilization; implying that service utilization is an important proof of healthcare access in Africa.

Healthcare workers\u2019 behaviors and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review

BackgroundHealthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services.MethodsA systematic review of literature was conducted to identify studies focusing on healthcare workers’ behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria.ResultsNegative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines.ConclusionsHealthcare workers’ negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA.Trial registrationA protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509.

A systematic review of supportive supervision as a strategy to improve primary healthcare services in Sub-Saharan Africa.

It may be assumed that supportive supervision effectively builds capacity, improves the quality of care provided by frontline health workers, and positively impacts clinical outcomes. Evidence on the role of supervision in Sub-Saharan Africa has been inconclusive, despite the critical need to maximize the workforce in low-resource settings. To review the published literature from Sub-Saharan Africa on the effects of supportive supervision on quality of care, and health worker motivation and performance. A systematic review of seven databases of both qualitative and quantitative studies published in peer-reviewed journals. Selected studies were based in primary healthcare settings in Sub-Saharan Africa and present primary data concerning supportive supervision. Thematic synthesis where data from the identified studies were grouped and interpreted according to prominent themes. Supportive supervision can increase job satisfaction and health worker motivation. Evidence is mixed on whether this translates to increased clinical competence and there is little evidence of the effect on clinical outcomes. Results highlight the lack of sound evidence on the effects of supportive supervision owing to limitations in research design and the complexity of evaluating such interventions. The approaches required a high level of external inputs, which challenge the sustainability of such models.

FROM ZARA TO ZAMBIA

Professor Jérémie Gallien is using his corporate supply-chain experience to improve vital healthcare services in sub-Saharan Africa

Case-fatality and disability in the Tanzanian Stroke Incidence Project cohort.

ObjectivesThe burden of stroke on healthcare services in sub‐Saharan Africa (SSA) is increasing. However, long‐term outcomes from stroke in SSA are not well described. We aimed to investigate case‐fatality and health outcomes for stroke survivors at 7‐ to 10‐year follow‐up.Materials and methodsThe Tanzanian Stroke Incidence Project (TSIP) recruited incidence stroke cases between 2003 and 2006. We followed up cases in 2013, recording date of death in those who had died.ResultsOf 130 stroke cases included in this study, case‐fatality and date of death data were available for 124 at 7–10 years post‐stroke. Of these, 102 (82.3%) had died by 7 years post‐stroke. Functional disability, as measured by the Barthel index immediately post‐stroke, was a significant predictor of case‐fatality at seven‐year follow‐up with those with severe disability having an almost four‐fold increase in the odds of death compared with those with no, mild or moderate disability.ConclusionsCase‐fatality rates are higher than reported in high‐income countries, with post‐stroke disability a significant predictor of death. Sustainable interventions to reduce post‐stroke disability in this setting should be investigated.