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Published in: Archives of Public Health 1/2017

Open Access 01-12-2017 | Research

Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities

Author: Tsegahun Manyazewal

Published in: Archives of Public Health | Issue 1/2017

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Abstract

Background

Acknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes health systems in terms of six building blocks. This study aimed to determine the current status of the six WHO health system building blocks in public healthcare facilities in Ethiopia.

Methods

A quantitative, cross-sectional study was conducted in five public hospitals in central Ethiopia which were in a post-reform period. A self-administered, structured questionnaire which covered the WHO’s six health system building blocks was used to collect data on healthcare professionals who consented. Data was analyzed using IBM SPSS version 20.

Results

The overall performance of the public hospitals was 60% when weighed against the WHO building blocks which, in this procedure, needed a minimum of 80% score. For each building block, performance scores were: information 53%, health workforce 55%, medical products and technologies 58%, leadership and governance 61%, healthcare financing 62%, and service delivery 69%. There existed a significant difference in performance among the hospitals (p < .001).

Conclusion

The study proved that the WHO’s health system building blocks are useful for assessing the process of strengthening health systems in Ethiopia. The six blocks allow identifying different improvement opportunities in each one of the hospitals. There was no contradiction between the indicators of the WHO building blocks and the health sustainable development goal (SDG) objectives. However, such SDG objectives should not be a substitute for strategies to strengthen health systems.
Literature
1.
Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2017;388(10063):3027–35.CrossRef
2.
Fowkes FJ, Draper BL, Hellard M, Stoové M. Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges. BMC Med. 2016;14(1):202.CrossRefPubMedPubMedCentral
3.
Bundhamcharoen K, Limwattananon S, Kusreesakul K, Tangcharoensathien V. Contributions of national and global health estimates to monitoring health-related sustainable development goals. Glob Health Action. 2016;9:32443.PubMed
4.
Tebbutt E, Brodmann R, Borg J, MacLachlan M, Khasnabis C, Horvath R. Assistive products and the sustainable development goals (SDGs). Glob Health. 2016;12(1):79.CrossRef
5.
GBD 2015 SDG Collaborators. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1813–50.CrossRef
6.
Kirigia JM, Pannenborg CO, Amore LG, Ghannem H, IJsselmuiden C, Nabyonga-Orem J. Global forum 2015 dialogue on "from evidence to policy - thinking outside the box": perspectives to improve evidence uptake and good practices in the African region. BMC Health Serv Res. 2016;16(4):215.CrossRefPubMedPubMedCentral
7.
Hafner T, Shiffman J. The emergence of global attention to health systems strengthening. Health Policy Plan. 2013;28(1):41–50.CrossRefPubMed
8.
Chapman AR. Assessing the universal health coverage target in the sustainable development goals from a human rights perspective. BMC Int Health Hum Rights. 2016;16(1):33.CrossRefPubMedPubMedCentral
9.
Mann C, Ng C, Akseer N, Bhutta ZA, Borghi J, Colbourn T, et al. Countdown to 2015 country case studies: what can analysis of national health financing contribute to understanding MDG 4 and 5 progress? BMC Public Health. 2016;16(2):792.CrossRefPubMedPubMedCentral
10.
Manyazewal T, Oosthuizen MJ, Matlakala MC. Proposing evidence-based strategies to strengthen implementation of healthcare reform in resource-limited settings: a summative analysis. BMJ Open. 2016;6(9):e012582.CrossRefPubMedPubMedCentral
11.
12.
World Health Organization (WHO). Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva, Switzerland: WHO;2010.
13.
Marinucci F, Manyazewal T, Paterniti AD, Medina-Moreno S, Wattleworth M, Hagembe J, et al. Impact of horizontal approach in vertical program: continuous quality improvement of malaria and tuberculosis diagnostic services at primary-level medical laboratories in the context of HIV care and treatment program in Ethiopia. Am J Trop Med Hyg. 2013;88(3):547–51.CrossRefPubMedPubMedCentral
14.
Swanson RC, Atun R, Best A, Betigeri A, de Campos F, Chunharas S, et al. Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions. Glob Health. 2015;11:5.CrossRef
15.
Goldberg J, Bryant M. Country ownership and capacity building: the next buzzwords in health systems strengthening or a truly new approach to development? BMC Public Health. 2012;12:531.CrossRefPubMedPubMedCentral
16.
van Olmen J, Marchal B, Van Damme W, Kegels G, Hill PS. Health systems frameworks in their political context: framing divergent agendas. BMC Public Health. 2012;12:774.CrossRefPubMedPubMedCentral
17.
Mounier-Jack S, Griffiths UK, Closser S, Burchett H, Marchal B. Measuring the health systems impact of disease control programmes: a critical reflection on the WHO building blocks framework. BMC Public Health. 2014;14:278.CrossRefPubMedPubMedCentral
18.
Senkubuge F, Modisenyane M, Bishaw T. 2014. Strengthening health systems by health sector reforms. Glob health action. 2014;7:23568.CrossRef
19.
Obermann K, Chanturidze T, Richardson E, Tanirbergenov S, Shoranov M, Nurgozhaev A. Data for development in health: a case study and monitoring framework from Kazakhstan. BMJ Global Health. 2016;1:e000003.CrossRefPubMedPubMedCentral
20.
Mutale W, Bond V, Mwanamwenge MT, Mlewa S, Balabanova D, Spicer N, et al. Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study. BMC Health Serv Res. 2013;13:291.CrossRefPubMedPubMedCentral
21.
Fisher JR, Cabral de Mello M. Using the World Health Organization's 4S–Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings. Int J Ment Health Syst. 2011;5:23.CrossRefPubMedPubMedCentral
22.
23.
24.
25.
Federal Democratic Republic of Ethiopia Ministry of Health (FMoH). Standards for access and quality of health service. FMoH 2007. Addis Ababa, Ethiopia.
26.
Adds Ababa City Government Health Bureau (AAHB). Standard operation procedure for the delivery of medical services. AAHB curative services core process 2008. Addis Ababa, Ethiopia.
27.
Warner RM. Applied statistics: from bivariate through multivariate techniques. 2nd ed. USA: SAGE Publications, Inc; 2013.
28.
Shakarishvili G, Lansang MA, Mitta V, Bornemisza O, Blakley M, Kley N, et al. Health systems strengthening: a common classification and framework for investment analysis. Health Policy Plan. 2011;26(4):316–26.CrossRefPubMed
29.
30.
Moon S. WHO's role in the global health system: what can be learned from global R&D debates? Public Health. 2014;128(2):167–72.CrossRefPubMed
31.
McNatt Z, Linnander E, Endeshaw A, Tatek D, Conteh D, Bradley EH. A national system for monitoring the performance of hospitals in Ethiopia. Bull World Health Organ. 2015;93(10):719–26.CrossRefPubMedPubMedCentral
32.
Busse H, Aboneh EA, Tefera G. Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University's Tikur Anbessa Specialized Hospital (Ethiopia). Glob Health. 2014;10:64.CrossRef
33.
Wispelway BP. Rethinking responsibility in global health: a case from Ethiopia. Social Medicine in Practice. 2016;9(3):129–31.
34.
Manyazewal T, Matlakala MC. Beyond patient care: the impact of healthcare reform on job satisfaction in the Ethiopian public healthcare sector. Human Resource for Health. 2017;15:10.CrossRef
35.
Olukoga A, Bachmann M, Harris G, Olukoga T, Oluwadiya K. Analysis of the perception of institutional function for health sector reform in Nigeria. International Health. 2010;2(2):150–5.CrossRefPubMed
36.
Ganjian S, Dowling PT, Hove J, Moreno G. What physicians from diverse specialties know and support in health care reform. Fam Med. 2015;47(4):283–91.PubMedPubMedCentral
37.
Flottorp SA, Jamtvedt G, Gibis B, McKee M. Using audit and feedback to health professionals to improve the quality and safety of health care. World Health Organization, on behalf of the European Observatory on Health Systems and Policies. Copenhagen, Denmark; 2010.
38.
Ethiopian Public Health Institute (EPHI). Improving health care financing in Ethiopia: an evidence brief for policy. Addis Ababa, Ethiopia: EPHI; 2014.
39.
Kebede A, Gebreslassie M, Yitayal M. Willingness to pay for community based health insurance among households in the rural community of Fogera District, north West Ethiopia. International Journal of Economics, Finance and Management Sciences. 2014;2(4):263–9.CrossRef
40.
Engeda EH, Birhanu AM, Alene KA. Intent to stay in the nursing profession and associated factors among nurses working in Amhara regional state referral hospitals. Ethiopia BMC Nursing. 2014;13(24):1–8.
41.
Negussie N. Relationship between rewards and nurses’ work motivation in Addis Ababa hospitals. Ethiopian Journal of Health Science. 2012;22(2):107–12.
42.
Yami A, Hamza L, Hassen A, Jira C, Sudhakar M. Job satisfaction and its determinants among health workers in Jimma university specialized hospital, southwest Ethiopia. Ethiopian Journal of Health Science. 2011;21:19–27.
43.
Assefa F, Mosse A, H/Michael Y. Assessment of client satisfaction with health service deliveries at Jimma university teaching hospital. Ethiopian Journal of Health Science. 2012;21(2):101–9.
Metadata
Title
Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities
Author
Tsegahun Manyazewal
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2017
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-017-0221-9

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