Service Delivery Outcomes Research Articles

A systematic review of the clinical practice guidelines for the assessment, management and treatment of eating disorders during the perinatal period

BackgroundEating disorders during the perinatal period can pose significant risks to both the mother and the baby. Clinical practice guidelines include statements of expected practice intending to improve effectiveness and quality of care within health care services. This systematic review aimed to identify and synthesise current clinical practice guideline recommendations on the assessment, management and treatment of eating disorders during the perinatal period.MethodsThree bibliographic databases and five guideline repository databases were searched alongside the grey literature. Guidelines were screened against eligibility criteria and recommendations for the assessment, management or treatment of eating disorders during the perinatal period were extracted. All included guidelines were assessed for quality using the AGREE-II tool. Recommendations were analysed and summarised using narrative synthesis.ResultsFrom the 242 records screened, 17 met inclusion criteria. Guideline quality ranged from three out of seven to seven out of seven. Six overall recommendations were formed from the narrative synthesis of data: 1) Early detection: recognising the signs and symptoms, 2) Assessment and screening: a three-pronged approach, 3) Educating and supporting the mother: the importance of knowledge, 4) Cross-system collaboration, 5) Psychological, pharmacological and medical treatment, and 6) Continued monitoring.ConclusionPerinatal eating disorder guideline recommendations were fairly consistent but showed considerable variability in quality and depth of recommendations. Recommendations require further contextualisation, to allow them to be operationalised and implemented within services. The review findings provide an initial framework for health care professionals responsible for supporting women with eating disorders during the perinatal period, and have several implications for policy, service delivery and health outcomes for women and their families.

Healthcare provider perspectives on integrating HIV care into cancer centers in Malawi, South Africa, Uganda, and Zimbabwe.

In East and Southern Africa, treatment of people with concomitant cancer and HIV is complicated by siloed service delivery pathways, which exacerbate barriers to care and impact clinical decision-making. Integrating HIV care into cancer treatment centers may improve service delivery and overall patient outcomes. We administered a questionnaire to clinicians and support staff at tertiary cancer referral centers in Malawi, Zimbabwe, Uganda, and South Africa to assess level of concern about clinical management of people with HIV (PWH) and cancer, barriers to integrating HIV service delivery into cancer treatment delivery, and beliefs related to HIV, antiretroviral therapy (ART), and integrated care. Of 195 clinician and support staff participants, 165 (85 %) were direct providers of cancer-associated care. Over 50 % indicated that they held concerns about survival, treatment complications, co-morbidities, and drug-drug interactions in PWH compared to patients without HIV. Over 80 % agreed that knowing cancer patients' HIV status, ART status, and ART regimen would facilitate better care and should be considered in cancer care decision-making. Overall, respondents were optimistic that HIV-related care could be easily integrated into cancer care provision. The most-frequently endorsed barriers to integrated care were workspace limitations, disruptions to workflow, availability of staff, and cost to the hospital and to patients. Cancer clinicians and support staff report overall positive attitudes toward integrating HIV and cancer service delivery. Research to elucidate service delivery pathways and contextualize system-based barriers to integrating care are critical next steps to optimize linked HIV and cancer care delivery.

Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women's Self-Reported Care-Seeking Pathways.

Timely access to emergency obstetric care (EmOC) remains a challenge in sub-Saharan Africa, influenced by poor health care utilization and rapid urbanization. Studies show poor maternal health outcomes in African cities, reflecting weak health systems. Understanding care-seeking pathways is key to improving service delivery and health outcomes. We examined self-reported care-seeking pathways among women with obstetric complications in Kampala City, Uganda. In this cross-sectional survey, we collected sequential data from 433 women (15-49 years) from 9 health facilities in Kampala City. We developed typologies of common pathways to EmOC and descriptively analyzed key attributes, including median time spent at each step, comparing pathways across complications and participant characteristics. Provider utilization and service delivery performance issues were also assessed. Participants' average age was 26 years (standard deviation=6), with 55% (237/433) living outside Kampala. We identified 4 common pathways based on number and location of steps: pathways with 1 step, directly to a facility that provided required care (42%, 183/433); 2 steps, mostly including direct facility referrals (40%, 171/433); 3 steps (14%, 62/433); and 4 or more steps (4%, 17/433). Comprehensive EmOC facilities referred elsewhere 43% (79/184) of women who initially sought care in these facilities. Peripheral facilities referred 65% of women directly to the national referral hospital. A majority (60%, 34/57) of referred women returned home before reaching the final care facility. Our findings suggest that care pathways of women with obstetric complications in Kampala often involve at least 2 formal providers and reflect possible inefficiencies in the referral process, including potential delays and unnecessary steps. Efforts to strengthen urban health and referral systems should adopt multidisciplinary and integrated approaches, supported by clear policies and structures that facilitate effective interfacility and interdistrict care coordination. This should include streamlined care/referral pathways and equitable emergency transportation systems.

Legal Challenges in Hospital Management and Their Impact on the Quality of Healthcare

Legal issues present significant challenges to healthcare quality by introducing barriers such as regulatory compliance requirements, conflicts over patient rights, and medical malpractice risks. These challenges often lead to increased operational costs, higher litigation risks, and diminished patient trust. This study examines how hospital administrators can effectively manage legal risks related to healthcare laws, identifying strategies to mitigate these challenges to improve healthcare quality and patient satisfaction while minimizing legal disputes. The research evaluates existing legal frameworks, reviews case studies of legal disputes in healthcare, and analyzes risk management practices adopted by administrators. Findings highlight that implementing legal compliance systems, providing staff training on relevant laws, and fostering collaboration with legal experts are critical strategies. These measures not only reduce risks of litigation but also enhance operational efficiency and bolster patient trust. By addressing the intersection of legal theory and healthcare practice, the study offers actionable recommendations for healthcare institutions. It underscores the importance of proactive legal risk management in improving service delivery, institutional reputation, and patient outcomes.

Perspectives of healthcare professionals on cross-sectoral collaboration between mental health centers and municipalities: A qualitative study.

This paper aims to explore the intricacies of cross-sectoral collaboration in mental health care, focusing on the perspectives of health professionals across various disciplines. It seeks to understand how collaboration can enhance service delivery and patient outcomes while identifying existing challenges. The evolving healthcare landscape emphasizes the importance of integrating services across sectors, particularly in mental health care, to improve continuity and efficiency of care. The study utilizes qualitative methods to investigate health professionals' experiences with cross-sectoral collaboration in mental health services. Purposive sampling was used to select 21 health professionals for focus group discussions held at a mental health center in Region Zealand, Denmark. Data was collected through these discussions, and content analysis was performed to extract key themes. The data collection took place in 2022. Health professionals recognized the potential benefits of cross-sectoral collaboration, such as enhanced service delivery and improved patient outcomes. However, significant barriers were identified, including bureaucratic obstacles, communication gaps, and insufficient organizational support. Cross-sectoral collaboration in mental health care offers significant advantages, but challenges must be addressed to fully realize its potential. Efforts should focus on policy reforms, organizational support, and fostering interdisciplinary communication to improve care delivery.

The Influence of Online Tax Services on Service Delivery at Kenya Revenue Authority – Nakuru Station

Purpose: This study examined the influence of Online Tax Services on service delivery at the Kenya Revenue Authority (KRA) Nakuru Station. Methods: Utilizing a descriptive case study research design, the study targeted a population of 504 staff and customers at the station. A sample size of 287 was derived using Yamane’s (1967) formula. Results: The findings reveal a moderate positive correlation (Pearson correlation coefficient of 0.538) between Online Tax Services and service delivery, indicating that improvements in the availability and functionality of these services are associated with better service delivery outcomes. Regression analysis further confirms that Online Tax Services significantly impact service delivery, with an unstandardized coefficient of 0.317 and a standardized coefficient of 0.271. This suggests that enhancing these services results in a moderate improvement in service delivery. Respondents also noted the benefits of reduced processing times, increased accuracy of tax assessments, and improved taxpayer compliance. However, concerns about staff training and readiness indicate a need for further capacity-building efforts to fully optimize the benefits of digitization. Conclusion: The study concludes that while Online Tax Services positively influence service delivery, additional focus on staff engagement and system reliability is essential for sustained improvements.

Audit, Transparency, and Future Directions for the Sehat Card Plus Program: Insights and Recommendations

The Sehat Card Plus program in Khyber Pakhtunkhwa (KP), Pakistan, launched to provide free healthcare services, has faced growing demand as it now extends from inpatient (IPD) to outpatient (OPD) services. Despite its transformative potential, the program struggles with transparency, resource allocation, and accountability issues that compromise service delivery and patient outcomes. This study critically examines the program’s operational challenges using data from various healthcare facilities across KP, highlighting significant shortages in medical equipment, inadequate fund distribution, and inefficiencies within the program’s administrative processes. Recommendations for stricter audit protocols and improvements in operational transparency are provided to enhance the program’s effectiveness

Improving transparency in malaria programme funds: A business case for connected diagnostics in Kenya.

International vertical health financing programmes risk functioning in parallel with existing domestic funding in low- and middle-income countries (LMICs), leading to inefficient service delivery and concomitant poor health outcomes. We assessed the opportunities offered by digitalised diagnostics (ConnDx) to target and monitor health funds to those in need objectively and transparently. ConnDx was rolled out in five private health facilities in Kisumu, Kenya. The ConnDx process was codeveloped with the local Department of Health of Kisumu. We used the quantitative data generated by ConnDx. We also calculated the costs for ConnDx and standard care to assess potential cost reductions. In total, 2199 malaria cases were detected among 11 689 patients with fever. ConnDx allowed for the identification of malaria hotspots, semi-real-time assessment of patient health seeking behaviour across facilities and insights in doctor's prescription behaviours. Based on these insights, we estimated a 25% reduction in costs can be realised, while simultaneously better quality indicators can be monitored. The concept of ConnDx can be used for any medical condition that can be diagnosed in a digital manner and linked to mobile payment systems. The generated data can contribute to better quality services for individual patients while at the same time support local health policy makers and managers for more targeted interventions. The ConnDx approach can help decision makers in LMICs to channel disease-specific funds to the right patients for the right disease at the right time, which can potentially accelerate the way to universal health coverage.

Examining the Effects of Health Work Shortages and Deployment in Integrated Programme in Bihar, India: AnInstitutional Ethnography.

The integration of health programms in low-resource settings is a common approach aimed at providing quality and cost-effective healthcare services. However, programme integration can unintentionally impact service provision and disrupt the overall organisation of service delivery. In this paper, I examine the integrated programme for non-communicable diseases (NCDs) and explore the challenges related to the deployment of health workers. Specifically, I investigate the institutional processes that shape the work of health workers and the working conditions in district hospitals. To explore the social organisation of the implementation of the integrated NCD programme, I employed institutional ethnography as a research method. Data collection involved interviews, participant observation, and document reviews. Data analysis was conducted using social mapping, analytical writing, and textual analysis methods. The findings of the study suggest that due to staff shortages and a lack of doctors, health workers are continuously subjected to deployment and often required to undertake multiple tasks and responsibilities without any incentives or non-monetary benefits. Administrators perceive health workers in integrated programs as additional human resources available for use in district hospitals. However, the removal of health workers from integrated programs can have negative implications for service delivery and patients' health outcomes. Finding of the study suggests that it is recommended that administrators improve the staff recruitment process and promptly address the grievances of health workers to enhance healthcare delivery.

Optimizing last-mile delivery of essential medicines in Nigeria: Insights from Niger State’s health-care supply chain

Last-mile delivery of health commodities is a critical component of efficient supply chains, and third-party logistics (3PL) providers are pivotal in ensuring cost-effective and reliable product distribution. This study explores the implementation of last-mile delivery outsourcing by government-operated warehouses and drug management agencies (DMAs). This research focuses on the relationship between 3PL utilization and key performance metrics, such as cost reduction, timely delivery, and end-user satisfaction. This study combines a literature review, surveys, and interviews conducted with employees of the DMAs in Minna, Niger State, to establish significant correlations. The findings show that using 3PLs significantly reduced operational costs, improved the frequency of timely deliveries, and enhanced end-user satisfaction. These findings underscore the need for continued engagement with 3PL providers to optimize supply chain performance and improve service delivery outcomes. Managers are recommended to maintain and expand such collaborations to sustain these benefits.

Identifying the active ingredients in payment for performance programmes using system dynamics modelling

Payment for performance (P4P) is not a uniform intervention, with programme effect dependent on several interconnected factors. In this study, a system dynamics model was developed to explore the pathways to improved outcomes and how changes in the design, implementation and context of a P4P programme affected maternal and child health (MCH) service delivery outcomes in Tanzania. A previously developed causal loop diagram of the programme effects was used to inform model development, with further data sources (including an impact evaluation of programme, health surveys, stakeholder feedback and relevant literature) used to build the model. A number of pathways were identified to improved services under P4P, with increased availability of drugs underpinning the content of care outcome (intermittent preventative treatment during ANC), which together with increased supervision, enhanced health worker motivation. This in turn increased perceived quality of care at the facility which improved the coverage of services outcome (facility-based deliveries), and with increased outreach, increased awareness of services also boosted demand. Minor delays in payment reduced provider purchasing power for medicines, with severe delays driving erosion of provider trust and motivation for programme participation. Allocating a larger share of funds for facility operations can enhance performance effects, particularly for those services that rely on efficient drug administration. Contextual factors including limited baseline provision of essential medications, lower community awareness of facility services and dispersed/distant populations reduced programme effect. This paper demonstrates the feasibility and the potential of such models to inform the design of effective health system interventions.

Digital health spaces in the city of Lisbon. The role of digitalization in linking boundaryless hospitals and smart health cities

Abstract Digital transformation is reshaping every aspect of society, including healthcare. The concepts of ‘Boundaryless Hospitals’ (BH) and ‘Smart Health Cities’ (SHC) represent a forward-thinking approach to healthcare that leverages digital technologies to enhance service delivery, operational efficiency and patient outcomes, including healthy mobility. This session delves into the complex role of digitalization in creating interconnected health and spatial environments where the flow of data and resources across physical and virtual barriers is optimized. BH embody a healthcare model where digital tools, health information systems and AI-powered diagnostics are integrated to provide care that transcends traditional hospital walls into the city. This approach not only facilitates greater accessibility and flexibility in patient care but also enhances the capacity for healthcare providers to offer personalized and timely interventions, embracing public health altogether. SHC integrates health technology into urban planning and public health services to create ecosystems that actively contribute to the health and wellbeing of their populations. Using big data analytics, IoT and other digital infrastructures, these cities support sustainable health practices, disease prevention, and efficient crisis response, promoting an overall healthier populace. This session will explore how digital health spaces can bridge the gap between these concepts. Discussions will focus on public health challenges and opportunities, examining the case of the city of Lisbon on how digital platforms can facilitate interactions between healthcare providers, patients, and urban environments. Best practices from pioneering projects around the globe will be highlighted. Participants will engage in comprehensive analyses of Lisbon case that demonstrate successful integration of digital health technologies in various contexts, contributing to the resilience and adaptability of healthcare infrastructures.

Enhancing Change Management for Improved Public Service Delivery: A Study of Kampala Capital City Authority (KCCA)

Purpose: This study aimed to investigate the role of change management in improving service delivery within government parastatals in Uganda, specifically focusing on the Kampala Capital City Authority (KCCA). It explored the enabling factors for change management on service delivery and assessed the effects of change management on service delivery within these parastatals. Methodology: The study employed a cross-sectional and exploratory approach, utilizing both quantitative and qualitative methods. The study population consisted of 298 participants from various departments within KCCA. Data collection methods included self-administered questionnaires, interviews with key informants, and documentary reviews. The study instruments were validated using the Content Validity Index, and reliability was assessed using Cronbach’s Alpha coefficient. Quantitative data were analyzed using descriptive statistics, correlation analysis, and bivariate regression, while qualitative data were analyzed through content analysis. Findings: The study concluded that the enabling factors for change management on service delivery in government parastatals in Uganda are not well understood. Additionally, it found that change management does have a significant impact on service delivery within these institutions. Unique contribution to theory, practice and policy (recommendations): Based on the conclusions, it is recommended that KCCA administrators enhance service delivery through a more holistic approach to change management. This should involve addressing various enabling factors and components of the change management framework to optimize service delivery outcomes.

Implementing national care guidelines in local authorities in England and Wales: a theory-of-change

BackgroundThe delivery of high-quality services in chronically underfunded social or long-term care systems is a major challenge internationally. National guidelines, developed by the National Institute for Health and Care Excellence, set out how local authorities in England and Wales should fund and provide care based on best available evidence. Theoretical and participatory approaches can usefully inform the design and evaluation of implementation strategies for guidelines. The aim of the study is to develop a Theory-of-Change for how the implementation of these guidelines is expected to lead to impacts from a local authority perspective.MethodsAs part of a comparative case study (The ‘Valuing Care Guidelines’ study; February 2022 to April 2024) with three local authority sites in England and Wales, we involved altogether 17 participants in two Theory-of-Change online workshops per site, each of 2 hours. Additional data gathered from the same participants as part of the overall study were used to conceptualise and enrich information from the workshops.ResultsParticipants described the Theory-of-Change map as follows: A wide range of activities (categorised in stages of ‘pre-implementation’, ‘implementation’, ‘sustainment and scaling’) and skills were required to implement guidelines, and achieve long-term organisational sustainability and service delivery outcomes, leading to final impacts for service users and carers. Participants described a co-creation implementation model, led by ‘Implementation Support Practitioners’, who utilised relational skills to achieve motivation, trust, and confidence at different organisational levels, addressing contextual barriers such as inadequate staffing, lack of resources and of organisational support systems. Consistent use of guidelines by frontline staff could only be achieved if the value of guideline implementation was promoted widely, and if consideration was given to the roles of stakeholders, such as the inspection body, local health care providers, users and carers.ConclusionsOur study is the first to investigate the implementation of national social care guidelines by local authorities in England and Wales. It generates insights that can guide implementation practice as well as inform the evaluation of future implementation strategies.

Impact of the COVID-19 pandemic on maternal, neonatal and child health service utilisation, delivery and health outcomes in Gauteng province, South Africa: an interrupted time series (ITS) analysis.

Gauteng was one of the provinces in South Africa most hit by COVID-19. However, there has been no assessment of the pandemic's impact on essential maternal, neonatal and child health (MNCH) services in Gauteng, for planning against future emergencies. This study sought to assess the impact of the COVID-19 pandemic on essential MNCH service utilisation, delivery and health outcomes in Gauteng province. We employed a quasi-experimental interrupted time series (ITS) study design, using the District Health Information System (DHIS) data set to evaluate the impact of COVID-19 on eight key MNCH indicators between March 2019 to February 2021. Using Stata V.17.0 and 5% alpha, a segmented linear regression (ITS) model quantified the trends of the indicators before COVID-19 (March 2019 to February 2020) (β1), the immediate change in level due to the March 2020 lockdown (β2), the post-lockdown (March 2020 to February 2021) trend (β4) and the change in gradient from before to after the lockdown (β3). COVID-19 lockdown exerted a significant decline in primary healthcare headcount<5 years (n) (β2= -60 106.9 (95% CI, -116 710.4; -3503.3), p=0.039); and postnatal care visits within 6 days (rate) (β2=-8.2 (95% CI, -12.4; -4.1), p=0.001). Antenatal care first visits before 20 weeks (rate) declined during COVID-19 (β3=-0.4 (95% CI, -0.7; -0.1), p=0.013) compared with the pre-COVID-19 period. COVID-19 adverse effects on service delivery (measles second dose coverage and fully immunised<1 year) and health outcomes (facility deaths 0-6 days, maternal mortality ratio and pneumonia case fatality<1 year) were insignificant. While some indicators post-lockdown attempted to recover, others deteriorated. In Gauteng province, the COVID-19 pandemic significantly disrupted essential MNCH service utilisation, particularly during the March 2020 lockdown. The mechanism of MNCH service disruption by COVID-19 was induced by both supply and demand services. It is imperative to strike a balance between maintaining routine healthcare services and managing an outbreak.

Cross-cultural design in costume: case study on totemic symbols of China and Thailand

Cross-cultural design has emerged as a pivotal domain of significance within the context of globalization. In the field of cross-cultural design, designers are tasked with addressing user requirements and identity characteristic contexts across diverse cultural backgrounds, aiming to achieve enhanced service delivery and cultural dissemination outcomes. Nonetheless, the landscape of contemporary fashion design research exhibits a noticeable dearth in studies that effectively integrate with cross-cultural design. This study selects the iconic cultural symbols of the Chinese loong (dragon) and Thai naga as case subjects, embarking upon research that employs costume design as a medium and bridge for cross-cultural design and communication. The research methodology integrates qualitative and quantitative approaches, including field investigations, participatory research, and Analytic Hierarchy Process (AHP) analysis, thereby substantiating theoretical constructs through empirical investigation. The study proposes that cross-cultural costume design, undertaken with the purpose of cross-cultural communication, can be conceptualized as a cyclical process involving multiple encoding and decoding iterations. The research elaborates on how costume, functioning as a non-verbal language, serve as a medium for facilitating cross-cultural interactions. Furthermore, the design extraction of cultural symbols is approached through a four-tiered framework. By articulating its research perspective, methodologies, and design cases, this study contributes valuable insights to researchers and practitioners engaged in cross-cultural design and related fields.

Integrated care models for youth mental health: A systematic review and meta-analysis.

To evaluate the effectiveness of integrated models of mental healthcare in enhancing clinical outcomes, quality of life, satisfaction with care and health service delivery outcomes in young people aged 12-25 years. A secondary objective was to identify common components of integrated mental health interventions. A systematic review and meta-analysis of studies published 2001-2023 that assessed clinical or health service use outcomes of integrated care, relative to treatment as usual, for any mental health condition in 12-25 years old accessing community-based care. Of 11,444 titles identified, 15 studies met inclusion criteria and 6 studies were entered in the meta-analysis. Pooled effect size found integrated care was associated with a greater reduction in depressive symptoms relative to treatment as usual at 4-6 months (standardised mean difference = -0.260, 95% confidence interval = [-0.39, -0.13], p = 0.001). Of the seven studies reporting access or engagement, all reported higher rates of both in the intervention arm. The most frequent components of integration were use of a multidisciplinary team (13/15 studies), shared treatment planning (11/15) and workforce training in the model (14/15). Integrated models of mental healthcare are associated with a small, but significant, increase in effectiveness for depressive symptoms relative to treatment as usual. Given integrated care may increase access and engagement, future research should focus on assessing the impact of integrated care in a wider range of settings and outcomes, including clinical and functional recovery, satisfaction with care and system-level outcomes such as cost-effectiveness.

Service Delivery Models and Outcomes for Students With Disabilities

In this systematic literature review, we examine the corpus of empirical studies in education that use administrative data (i.e., population-level data) to describe and estimate the impacts of service delivery models for specially designed instruction on outcomes for students identified with special education needs. We focus on studies that use quantitative data analysis—either descriptive or causal—to answer questions about the relationship between special education service delivery models and student outcomes. We analyze seven studies, each of which finds a positive relationship between more time spent in general education classrooms and outcomes for students with disabilities (SWDs). In our analysis, we discuss the affordances and limitations of this type of analysis and opportunities for the field to expand data collection and analysis of population-level data in a way that better illuminates the state of special education services, both in the present and longitudinally, for SWDs.

Patient-resident physician communication – a qualitative study to assess the current state, challenges and possible solutions

BackgroundPatients perceive effective patient-doctor communication as an important metric when evaluating their satisfaction with health systems. Hence, optimal patient-physician communication is fundamental for quality healthcare. High-income countries (HICs) have extensively studied patient-resident communication. However, there is a dearth of similar studies in low- and middle-income countries (LMICs). Therefore, we aimed to explore the current state of and barriers to practicing good patient-resident communication and explore possible solutions to mitigate these challenges at one of the largest Academic Medical Centers in an LMIC.MethodsThis study employed an exploratory qualitative study design and was conducted at the Aga Khan University Hospital in Pakistan. Through purposive maximum variation sampling, 60 healthcare workers from diverse cohorts, including attendings, fellows, residents, and medical students, participated in eight focus group discussions.ResultsWe identified three key themes from the data: Status-quo of residents’ communication skills and learning (Poor verbal and non-verbal communication, inadequate training programs, and variable sources of learning), Barriers to effective communication (Institutional barriers such as lack of designated counselling spaces, lack of resident insight regarding effective communication and deficits in intra-team communication), and the need for developing a communication skills curriculum (Design, implementation and scaling to other cohorts of healthcare workers).ConclusionsFindings from this study show that multifaceted factors are responsible for inadequate patient resident-physician communication, highlighting the need for and importance of developing a formal communication skills training curriculum for residents. These insights can be used to create standardized training for equipping residents with adequate skills for effectively communicating with patients which can improve healthcare service delivery and patient outcomes.

EVALUATING RESOURCE ALLOCATION MANAGEMENT TO HOSPITALS IN BAUCHI STATE: A CASE STUDY OF FEDERAL MEDICAL CENTRE AZARE AND PRIMARY HEALTHCARE CENTRE AZARE

Background: This study evaluates resource allocation management in hospitals in Bauchi State, focusing on Federal Medical Centre (FMC) Azare and Primary Healthcare Centre (PHC) Azare. The research addresses significant disparities in resource allocation that affect healthcare service delivery and patient outcomes. Methods: Using a mixed-method approach, the study combines quantitative data analysis of financial records, resource allocation reports, and healthcare service delivery metrics with qualitative insights from interviews and focus group discussions. Data Envelopment Analysis (DEA) was utilized to measure the relative efficiency of the hospitals in converting inputs such as financial resources, staff, and infrastructure into healthcare services and outputs. Additionally, descriptive analysis was conducted using IBM SPSS version 27 to analyze 100 questionnaire responses and demographic data. Results: The findings reveal significant disparities between FMC Azare and PHC Azare, with FMC Azare benefiting from more adequate financial resources, human resources, medical supplies, and infrastructure. These disparities lead to differences in patient satisfaction, service delivery efficiency, patient outcomes, and waiting times. Conclusions: The study underscores the need for more equitable resource allocation to improve healthcare delivery and patient outcomes at under-resourced centers like PHC Azare. Recommendations for policy interventions include addressing resource allocation inequities, staffing solutions, supply chain improvements, and infrastructure development. These recommendations aim to enhance resource allocation management, thereby improving healthcare services in Bauchi State and providing insights applicable to similar contexts in Nigeria, Africa, and globally. KEYWORDS: Resource Allocation Management, Healthcare Delivery, Data Envelopment Analysis (DEA), Federal Medical Centre, Primary Healthcare Centre.