Public Service Delivery System Research Articles

Lessons for Strengthening a Resilient Health System from the View of Health Facilities During the COVID-19 Pandemic: A Qualitative Study.

Coronavirus disease 2019 caused significant negative damage to the health status of populations and health systems globally. In Uganda, our previous study revealed that the strict Public Health and Social measures (PHSMs) and the closure of Entebbe Regional Referral Hospital (ERRH) led to missed healthcare access among the citizens in the Entebbe municipality. Limited studies, however, exist on the impact of the response measures on the local health systems. This study aims to explore the impacts of these measures on the local health service provision from the views of health facilities in Entebbe. We used a thematic framework method, grounded by the health systems resilience framework consisting of five components: (1) health service delivery; (2) medical products and technology; (3) health workforce; (4) public health functions; and (5) governance and financing. Key informant interviews with eight representatives from four private hospitals and four health centers were conducted from September to October 2022. Fifteen themes and 25 subthemes were identified. With the closure of the ERRH and the strict PHSMs, the citizens faced various difficulties in accessing the needed health services. The facilities received an overwhelming number of patients and faced various challenges, such as a lack of medicine, healthcare workers, facility capacity, and no means to transfer patients. Nevertheless, the facilities made efforts to maintain the required services. Moreover, mobilizing vertical and horizontal actors through a flexible network, from the district health office to community health volunteers, helped to coordinate the medicines, transportation for both patients and healthcare workers, conduct patient tracking, etc. Our study suggested the importance of an integrated system of public health and health service delivery systems, the formalization of a vertical cooperative mechanism, and the introduction of public health insurance for strengthening resilient health systems. These insights may benefit other sub-Saharan cities.

Exploring the Impact of Innovative Public Service Delivery System in Bangladesh: A Case Study of District Administration

Exploring the Impact of Innovative Public Service Delivery System in Bangladesh: A Case Study of District Administration

Mapping the Geographic Inequalities in Psychiatrist Distribution across Madhya Pradesh, India: An Exploratory Study

Objective: The National Mental Health Survey identified a vast treatment gap across India. This treatment gap is partly attributed to the availability and accessibility of mental health services in different states. Accessibility to a psychiatrist in Madhya Pradesh (MP) is essential due to the significant disparity among urban, rural, and tribal regions across the state. The study attempted to identify the geographical disparity of psychiatrists in MP to improve future mental health service delivery. Methods: An online survey of practicing psychiatrists was conducted in December 2022 in the settings of public and private healthcare service delivery systems through offline and online accessibility/availability of psychiatrists practicing in MP, and the data were mapped using geo-locations of psychiatrists and were analyzed using ArcMap 10.8.1. Results: In total, 152 psychiatrists were practicing in MP across 195 locations, which amounts to 0.21 psychiatrists per 100,000 population with a concentration around big cities. Out of 54 districts, 24 districts did not have any practicing psychiatrists. A total of 155 health facilities were identified across 30 (55.6%) districts where at least one psychiatrist provided mental health services. The nearest-neighbor index for 152 points was –13.69. Conclusions: Combining psychiatrist geo-mapping data with population data comprehensively explains the MP state’s mental health service delivery needs. It could be wise to improve the spatial distribution of psychiatrists in each district rather than achieving the recommended ratio of doctors to patients per state. These data need to be supplemented with qualitative inquiry to help policymakers and health planners generate effective public–private partnerships in mental health service delivery in the coming time.

Digital Referendum - Effective Modeling of Public Administration in Georgia

State management in its content is a complex and at the same time dynamic process. The second half of the 20th century can be considered the initial period of management transformation and establishment of governance structures.
 Governance based on democratic principles is based on a number of fundamental principles, the correct implementation of which is the most important prerequisite for the establishment of democratic institutions. One such important democratic process is the referendum.
 In Europe, the practice of referendum is most established in Switzerland, which is governed by a system of direct democracy. Accordingly, in order to solve problematic issues, citizens in Switzerland take part in both regional and national referendums, which are undoubtedly democratic in content and respond to the fundamental principles of modern public administration.
 In Georgia, where there is little experience in holding a referendum, the implementation of a digital referendum is the latest challenge, which will be an important step in the way of the country's European integration. The involvement of citizens in the solution of important issues for the state allows the so-called possibility of communication between society and government. It eliminates "black holes" and ensures the reduction of conflicts between them. Of course, all the positive results of the referendum depend on how fairly and objectively it will be conducted.
 Thus, one of the important challenges of the digitalization of the public administration of Georgia is the digital referendum, the implementation and development of which is an effective step on the way of the state development of Georgia and as a result ensures the acceleration of the country's institutional and European integration processes.
 In the era of digital governance, it is necessary to develop new approaches to state intervention in all spheres of public life and public service delivery systems in order to optimally respond to the needs of citizens. Analysis and comparison methods are mainly used in the work, proposals are given in the direction of improving the provision of public services in connection with the electronic referendum.

EFFECT OF COVID-19 PANDEMIC ON OCCUPATIONAL THERAPY PRACTICE AND IMPLEMENTATION OF TELEREHABILITATION INCLUDING HEALTH SECTORS IN AL AHSA CITY

Introduction and Aim: COVID-19 has turned into a worldwide public health emergency involving 223 nations and regions, and it has had a significant impact on public and health service delivery systems [1]. Tele-rehabilitation has developed as a potential strategy for virtually supervising the delivery of a physical, occupational, speech, and other therapies targeted at treating motor, mental, and neuropsychiatric deficiencies caused by sensory and motor impairments [3]. The transition to telerehabilitation offers a wealth of learning opportunities. This viewpoint offers an overview of how a learning health care system (LHS) approach to telerehabilitation research might foster innovation in health care delivery and lead to new scientific findings [4]. Telerehabilitation benefits minimize the need for patients and providers to travel and in-home rehabilitation services can save travel costs and caregiver strain. Patients with mobility issues will appreciate the convenience [5]. The aim of the study was to determine the COVID-19 pandemic effect on occupational therapy practice and use of telerehabilitation in Al-Ahsa. Method: COVID-19 pandemic effect on occupational therapy practice and use of telerehabilitation in Al-Ahsa assessed by the questionnaire. The purpose of the questionnaire to measure the Effect of Covid-19 pandemic on occupational therapy practice and implementation of telerehabilitation including government hospitals, private hospitals, and clinics in ALAHSA city. We shared the link by distributing it through social media. This study was conducted in Al-Ahsa including government hospitals, private hospitals, and clinics. The data collected from SPSS. 20 questions used to assess different aspects of COVID-19 pandemic effect on occupational therapy practice and use of telerehabilitation in Al-Ahsa with five options (Strongly Agree – Agree – Neutral – Disagree – Strongly Disagree. In addition, it is cross-sectional because the study collected data at giving point across the study. Result: There are 108 participants in this study. All of the participants were from Saudi Arabia in Al-Ahsa that met the inclusion criteria in This study. The number of male participants in the research was 85 (78.70%) . Also, the ages of the participants ranged from 16 to 58 and the average age is 30,23. We found that most of the participants agreed that telerehabilitation was effective and had many benefits for patients where the percentage of answers strongly agree and agree in all questions was high. Furthermore, the ages of the participants in the research are all of them from adolescence and adulthood, as the use of electronic technology to conduct therapeutic and rehabilitative sessions is almost non-existent for people in the late adulthood stage. Conclusion: We found that telerehabilitation is effective and benefits both the therapist and the patient. Also, the percentage of use of telerehabilitation by late adult patients was very low. Telerehabilitation had some problems and defects, and we hope that they will be resolved and the remote treatment system will be fully developed.

Analisis Kualitas Kinerja Pegawai Dinas Sosial Provinsi Sumatera Utara Bidang Program, Akuntabilitas Dan Informasi Publik Dalam Sistem Penyelenggaraan Pelayanan Publik

The aim of this research is: To determine the quality of performance of North Sumatra Province Social Service Employees, especially in the Program, Accountability and Public Information Sectors in the Public Service Delivery System. This study uses a qualitative method. Data collection was carried out through observation, interviews and documentation. The informants in this research were 4 people, namely the Secretary of the North Sumatra Province Social Service, Head of the Program, Accountability and Public Information Section, Program, Accountability and Public Information Officer, and Honorary Employees. The results of the research show that the quality of performance of North Sumatra Province Social Service employees in the areas of Programs, Accountability and Public Information is running well in accordance with employee performance. Based on interviews with informants, employees in the Program, Accountability and Public Information Division also have the same opinion regarding personal potential, optimal work results, work processes and enthusiasm at work. Therefore, it can be suggested that in the future, if you want to recruit new employees, pay more attention to the field of science or major according to the abilities of the prospective new employee so as to facilitate all better work processes in the Program, Accountability and Public Information fields.

E-public Service Delivery as an Innovative Paradigm-shift in Indian Governance System: An Analysis of Haryana State Model

A paradigm shift in the governance process is being observed because the Central and state governments have started working on Citizen’s Charters to deliver services within a time-frame. Information Communication Technology is playing a great role in fulfilling the service-delivery timelines according to the provisions of Right to Services Act, 2014. The Haryana government has come up with an innovative thesis for the SARAL platform ( Simple All-inclusive Real-time Action-oriented and Long-lasting), which intends to simplify and transform public-service delivery system. The objective of this article is to provide a platform for academic discourse by comparing the different public service delivery arrangements as citizens’ rights with the e-service delivery model of Haryana. The author analyses the e-services delivery process, grievances-redressal mechanisms, operational arrangements, working procedure of e-service delivery platform, e-seva scheme for Common Service Centres as prescribed in the Right to Services Act and e-service delivery model of Haryana.

Measuring disparities in access to district and referral hospitals in the city of Kigali, Rwanda

The study focused on the identification of theoretical and methodological constructs that can be used to analyse and improve the spatial performance of public health service delivery systems and the development of a corresponding spatial-analysis and GIS-based planning approach using the city of Kigali as a case study. Access to health care as a multi-tiered system was measured by using five dimensions of access, namely geographic accessibility, availability, affordability, acceptability and accommodation. Geo-statistical analysis was performed to measure and evaluate access to the district and referral health care. For geographic access, the travel time for every trip is approximated for the two main modes of transport (walking and public transport). To realistically represent the friction of distance, the street network was categorised into several road classes for which different travel speeds are estimated for each transport mode on the basis of local knowledge. A factor analysis model was used for availability, affordability, acceptability, and accommodation dimensions. Different indicators were evaluated in various units and scales and standardized to see how satisfaction levels varied with each dimension. Based on the type of indicator, for the cost or benefit, the score was zero (0) or one (1). One (1) was considered a positive impact, while zero (0) was considered a negative impact. Summary scores were developed for all indicators by combining more than one indicator into a single value. The created summary score also ranges from 0 to 1, and the higher the score, the better the access attainment. To find areas that need intervention, the comparison of all five indicators and the scores of access for each indicator was made. The dimensions of geographic accessibility and availability appeared to be the most problematic. The district health care dimensions have revealed a low performance level in geographic accessibility (0.64) and a high-performance level in affordability (0.94). The referral health care dimensions have revealed a low performance level of geographic accessibility (0.17) and a high-performance level of acceptability (0.92). Health planners and policy makers will commonly require such a planning method, particularly in the developing world where spatial contexts are highly dynamic as a result of rapid urbanisation.

Implementation Challenges of ICT in the Public Sector in Upazila Region of Bangladesh: An Empirical Study

Information and Communication Technology (ICT) plays a pivotal role in achieving Digital Bangladesh's vision of making the government accountable, transparent and effective in providing services to the citizens. The ICT-based governance (e-governance) in service delivery mechanism has become essential and time worthy. However, the implementation of e-governance is not up to the mark and the government is not getting the full benefits of e-governance due to the structural, organizational, and behavioral barriers. The dilemma between the service providers (agent) with numerous problems and the recipients’ viewpoints (principal) has been analyzed how the problem lies and the principal faces problem to get services. The objective of this study is to analyze the current situation of ICT-enabled Public Service Delivery; implementation challenges of ICT at the Upazila level of Bangladesh and come up with an evidence-based solution. To achieve the objectives, both qualitative and quantitative approaches were employed. Purposive random sampling was used to collect data through offline and online questionnaire surveys. Besides, interview and observation methods were also employed for strengthening the study findings. The study found that strong policy supports of the government i.e. ICT policy, and digital Bangladesh vision enable the e-government services to benefit the citizen. However, it is evident that the dearth of IT physical infrastructure, unstable internet connection, shortage of skilled manpower, and technology fear of public employees create obstacles to provide ITC-enabled services. Sometimes people’s unawareness also serves as barrier to receive e-government services. The study recommends improvement of internet speed, supply of continuous electricity supply, training of public employees, providing upgraded technology, and developing user-friendly softwares to address those problems and enhance ICT-induced public service delivery system. 
 Keywords: E-governance, Readiness, Public Service Delivery, Barriers, Way forward

Improving safe post-abortion care practices: A study on interventions implemented by Ipas Pakistan.

An estimated 50 million induced abortions occur in developing countries annually, and an estimated 7 million women are treated for complications associated with unsafe abortions. According to a 2012 estimate, 15 per 1,000 women aged 15-49 years seek treatment for abortion-related health complications in both private and public sectors. A high unmet need for family planning in Pakistan and a low percentage of women adopting a contraceptive method in the post-partum period led to unwanted pregnancy becoming one of the reasons for unsafe abortion. Post-abortion care (PAC) is an integrated service delivery model that includes both maternal health and family planning interventions. The study aims to examine improvement in abortion-related practices through the implementation of the PAC model at all tiers of public health service delivery systems in the two most populous provinces-Punjab, Sindh, Khyber Pakhtunkhwa, and Islamabad Capital Territory (ICT) region-of Pakistan. The improvement model comprises clinical training of healthcare providers, community engagement, and counseling of community women on safe post-abortion practices. It was a descriptive study utilizing data of 27,616 PAC clients recorded and reported by the service providers on the logbooks from 104 selected public health facilities from March 2018 to December 2021 in ICT, Punjab, Sindh, and Khyber Pakhtunkhwa provinces of Pakistan. Women who received PAC services were older than 25 years, 22,652 (82%), with a mean age of 29 years. Most of these women were in their first trimester, 26,110 (95%), and the majority diagnosed with PAC (incomplete, missed, or threatened abortion), 26,838 (97%). The majority of women, 25,324 (92%), received safe methods for post-abortion care that included the use of misoprostol, 15,804 (58%), and manual vacuum aspiration, 8,898 (32%). In total, 17,105 (72%) of women opted for a contraceptive method that included long-acting reversible contraceptives, 2,313 (10%); short-term excluding condoms, 3,436 (27%); and condoms, 8,113 (34%). The key predictors identified for uptake of the post-abortion family planning method indicated that women more than 25 years of age, in the early second trimester, and who were counseled on post-abortion family planning were more likely to adopt the contraceptive method than others. Increased access to post-abortion care and family planning could potentially reduce the incidence of unsafe abortion, unintended pregnancies, and associated maternal mortality. The experience of Pakistan suggests that the integrated post-abortion care service delivery model can be effectively implemented across the public health systems.

Public Service Delivery System in State Universities and Colleges: Controversies and Best Practices Across Frontline Services

Public Service Delivery System in State Universities and Colleges: Controversies and Best Practices Across Frontline Services

Comprehensive Overview of the Gambia's Health Landscape

The Gambia faces a challenge in healthcare accessibility, with a relatively sparse distribution of healthcare facilities. However, there is a positive trend with the construction of new health clinics across the country. The public health service delivery system in the Gambia is structured into three tiers, in line with the primary healthcare strategy.

Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

A basic study of service delivery system building for the Filial Piety behavior encouragement and aid

Background: Nevertheless the law of Filial Piety behavior encouragement and aid was enacted long time ago, still concrete and relevant service delivery system was not built. A detailed service system was needed for effectiveness of the law. Purpose: The purpose of this study was as follows as a review of service delivery system building for Filial Piety behavior encouragement and aid: First, review the publicity of the service which was provided by the country and the local government to validate the service of the Filial Piety behavior encouragement and aid. Second, inspect the essential matters for the design to the delivery system and consider the items based on the law. And the last, contemplate the principles of integration for the building of service delivery system. Methodology/Approach: With this reason, to review the literature of public service delivery system including social welfare to the law. Findings/Conclusions: Results show that first, there is a need for the contents review on the service. Second, since the service have a publicity, so called ‘the information of the Filial Piety behavior encouragement and aid service’should be published as the information of Senior Welfare service in the Ministry of Health and Welfare. Third, as the dimensions for the building of delivery system was not identified in the law, there is a need for considerations of the dimensions from the first step by step. And the last, there is a need for the considerations of the items of design of the delivery system and weakness from the literature view. Further, the inspection of the principles of integration should be considered with new building of the service delivery system. Implications: Implications for this study is to inform the law to the public, to perceive the Filial Piety behavior by the encouragement and aid from the government and the local one, to contribute the inheritance of Korean traditional culture and obedience of ethical norms

IMPACT OF ICT IN STRENGTHENING TRANSPARENCY IN RURAL LOCAL GOVERNANCE: A CASE STUDY IN FOUR GRAM PANCHAYATS IN WEST BENGAL, INDIA

The use of Information and Communication Technology (ICT) in local governance and public service delivery systems has added a new dimension in the recent times. In West Bengal, processes of decentralisation and institutional issues were assisted by special projects like SRD (Strengthening Rural Decentralisation) and ISGP (Institutional Strengthening of Gram Panchayats) respectively supported by DFID (2005-2011) and World Bank (2011-ongoing). Emphasis on GIS based monitoring of decentralised planning process, tracking key services provided by Gram Panchayats, use of GPMS (Gram Panchayat Management System) software for administrative and financial management are few of these key measures which rely on the use of ICTs in the local governance system. Apart from that, Ministry of Panchayati Raj has issued several guidelines on use of uniform portal like e-Gramswaraj for uploading Gram Panchayat Development Plans online. It is widely believed that issues like accountability and transparency can be ensured in the institutions of Gram Panchayats with advent of such measures. In this article we will analyse the effectiveness of ICT in bringing transparency and strengthen institutional accountability in the Gram Panchayats. Four Gram Panchayats in the District of Birbhumwere selected to understand how the effective implementation of ICT measures impact on the overall institutional strengthening of Gram Panchayats. For the purpose and the rigour of the study the GPs were selected on the basis of identified socio-economic and other important methodological indicators. Elected Representatives and local residents were selected as respondents. Gram Panchayats were visited for this purpose. For the collection of data structured questionnaire, personal interview, FGDs and case study methods were also used.The finding shows that the role of ICTs in the rural local governance process is limited. The administrative practices, monitoring of planning cycle, GPs financial management has improved undoubtedly but it is not a panacea as viewed by some experts. The study argues that limited involvement of the local residents in the process with low attendance in Gram Sabha and Gram Sansads meetings cannot be compensated with the modern technologies.

코로나19 확산 전후 삶의 만족도 영향요인의 차이 분석

The purpose of this study is to analyze changes in factors on citizens' life satisfaction before and during COVID-19 pandemic. According to the 2019 and 2021 Hwaseong-si(City) social surveys, it was found that citizen’s life satisfaction has increased during this period. However, as a result of analyzing the factors on citizens’ life satisfaction using a Ordered logit model, the influence of factors on citizens’ life satisfaction has changed. Especially economic factors(education level, income, debt status) have become more influential. This means that in the context of the spread of COVID-19, the gap in citizens' life satisfaction can be further widened by socio-economic factors. Through the results of this study, local governments will need a more meticulous approach to improve citizens’ life satisfaction in disaster situations. In a disaster situation, local governments need to closely observe changes in citizens' life satisfaction according to their socio-economic circumstances and establish flexible governance and public service delivery systems that can appropriately support welfare, medical, and health services.

Exploring quality of citizen service delivery system in the state of Karnataka, India

PurposeThe purpose of this paper is to understand the citizen perception of quality of service with respect to the Government’s citizen service delivery system of Karnataka and conduct an investigation to determine the major factors which affect the quality of Government service delivery system in the state of Karnataka in India.Design/methodology/approachPrimary data related to variables affecting citizen service satisfaction are collected using a questionnaire survey. The questionnaire was designed based on literature review and consulting officers associated with public service delivery system in the state of Karnataka.FindingsThe study found that the five factors “Responsiveness,” “Tangibility,” “Predictability,” “Reliability” and “Perceptiveness” are primary determinants of the quality of citizen/government services.Research limitations/implicationsRight to Service Act has been adapted by 24 states and 5 union territories in India. It is highly impossible to study the progress of Right to Service Act in each and every state of India. In this paper, the author has made a detailed study of state of Karnataka, which has the highest in-time service disposition rate −95.06%, highest number of institutions −99 and highest number of services −1,115 services under Right to Service Act in India and generalized the results for other states.Practical implicationsThis research enables government institutions/organizations to enhance their understanding of citizen service quality and perception of government services. The citizen satisfaction gauging parameters can provide useful direction to the design, implementation and management of government services.Social implicationsGovernment/citizen services include services provided by each and every department of the government. The services covered here begin from birth of individual as birth certificate service till the death of individual which includes death certificate, and in between this life cycle of an individual, important events such as service related to caste certificate, marriage certificate, service verification for job, property or Khatha certificate are included under government services, covering services related to all the major events of one’s life. The improved level of service quality can enhance service satisfaction among citizens resulting in good governance.Originality/valueThe paper addresses quality of Government services for the first time in the state of Karnataka, India using a carefully designed research study. This paper is of value to research scholars in the area of government service quality in India and other countries where government services are delivered either under Right to Services Act, in stipulated time frame or through citizen charters.

Experiences and Challenges of Implementing Universal Health Coverage With China's National Basic Public Health Service Program: Literature Review, Regression Analysis, and Insider Interviews.

BackgroundPublic health service is an important component and pathway to achieve universal health coverage (UHC), a major direction goal of many countries. China’s National Basic Public Health Service Program (the Program) is highly consistent with this direction.ObjectiveThe aim of this study was to analyze the key experience and challenges of the Program so as to present China’s approach to UHC, help other countries understand and learn from China’s experience, and promote UHC across the world.MethodsA literature review was performed across five main electronic databases and other sources. Some data were obtained from the Department of Primary Health, National Health Commission, China. Data obtained included the financing share of the national/provincial/prefectural government among the total investment of the program in 32 provinces in 2016, their respective per capita funding levels, and some indicators related to program implementation from 2009 to 2016. The Joinpoint regression model was adopted to test the time trend of changes in program implementation indicators. Face-to-face individual interviews and group discussions were conducted with 48 key insiders.ResultsThe program provided full life cycle service to the whole population with an equitable and affordable financing system, enhanced the capability and quality of the health workforce, and facilitated integration of the public health service delivery system. Meanwhile, there were also some shortcomings, including lack of selection and an exit mechanism of service items, inadequate system integration, shortage of qualified professionals, limited role played by actors outside the health sector, and a large gap between the subsidy standard and the actual service cost. The Joinpoint regression analysis demonstrated that 13 indicators related to program implementation showed a significant upward trend (P<.05) from 2009 to 2016, with average annual percent change values above 10% for 6 indicators and below 6% for 7 indicators. Three indicators (coverage of health records, electronic health records, and health management among the elderly) rose rapidly with annual percent change values above 30% between 2009 and 2011, but rose slowly or remained stable between 2011 and 2016. In 2016, the subsidy standard per capita in the eastern, central, and western regions was equivalent to US $7.43, $7.15, and $6.57, respectively, of which the national-level subsidy accounted for 25.50%, 60.57%, and 79.52%, respectively.ConclusionsThe Program has made a significant contribution to China’s efforts in achieving UHC. The Program focuses on a key population and provides full life cycle services for the whole population. The financing system completely supported by the government makes the services more equitable and affordable. However, there are a few challenges to implementing the Program in China, especially to increase the public investment, optimize service items, enhance quality of the services, and evaluate the health outcomes.

Barriers and facilitators of access to maternal, newborn and child health services during the first wave of COVID-19 pandemic in Nigeria: findings from a qualitative study.

BackgroundCOVID-19 pandemic may have affected the utilization of maternal and newborn child health services in Nigeria but the extent, directions, contextual factors at all the levels of healthcare service delivery in Nigeria is yet to be fully explored.The objective of the study was to explore the barriers and facilitators of access to MNCH services during the first wave of COVID-19 pandemic in Nigeria.MethodsA qualitative study was conducted among different stakeholder groups in 18 public health facilities in Nigeria between May and July,2020. In-depth interviews were conducted among 54 study participants (service users, service providers and policymakers) selected from across the three tiers of public health service delivery system in Nigeria (primary health centers, secondary health centers and tertiary health centers). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses.ResultsBarriers to accessing MNCH services during the first wave of COVID-19-pandemic in Nigeria include fear of contracting COVID-19 infection at health facilities, transportation difficulties, stigmatization of sick persons, lack of personal protective equipment (PPE) /medical commodities, long waiting times at hospitals, shortage of manpower, lack of preparedness by health workers, and prioritization of essential services.Enablers to access include the COVID-19 non-pharmacological measures instituted at the health facilities, community sensitization on healthcare access during the pandemic, and alternative strategies for administering immunization service at the clinics.ConclusionAccess to MNCH services were negatively affected by lockdown during the first wave of COVID-19 pandemic in Nigeria particularly due to challenges resulting from restrictions in movements which affected patients/healthcare providers ability to reach the hospitals as well as patients’ ability to pay for health care services. Additionally, there was fear of contracting COVID-19 infection at health facilities and the health systems inability to provide enabling conditions for sustained utilization of MNCH services. There is need for government to institute alternative measures to halt the spread of diseases instead of lockdowns so as to ensure unhindered access to MNCH services during future pandemics. This may include immediate sensitization of the general public on modes of transmission of any emergent infectious disease as well as training of health workers on emergency preparedness and alternative service delivery models.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-022-07996-2.

A Systematic Literature Review of E-Government Evaluation

The adoption of information and communication technology has had an effect on remodeling the general public service delivery system called e-government. E-government evaluation is a crucial aspect to evaluate how a long way the improvement in the quality of the public service delivery system provided by the technology. This study aim was to summarize and to decide the influencing factors in e-government evaluation by analyzing published scientific articles. This research method used a systematic literature review. The authors performed searches for scientific articles in online database Elsevier (Scopus) written in English and can be accessed in full paper. This study uses 18 articles of data to conduct a systematic literature review. The findings show that most previous studies on e-government service evaluation published in 2018 and 2020. The findings also show that developing countries are the most dominating research locations. In addition, the findings show the influencing factors in e-government evaluation are 1) user satisfaction consist of reliability/efficiency, compatibility, perceived of benefit, trust, responsiveness, overall satisfaction; 2) Site Quality consist of information quality, system quality, service quality, perceived usefulness, ease to use, accessibility, security and privacy, effectiveness, design, and content; 3) Facilitating condition consist of IT infrastructure. These twelve variables can be used as basis for future research to evaluate the quality of e-government. This study has limitations because it only uses the online database Elsevier (Scopus) as a database to obtain published scientific article data during 2014-2021.