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首页> 外文期刊>BMC Health Services Research >Comparison of maternal and child health service performances following a leadership, management, and governance intervention in Ethiopia: a propensity score matched analysis
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Comparison of maternal and child health service performances following a leadership, management, and governance intervention in Ethiopia: a propensity score matched analysis

机译：在埃塞俄比亚领导，管理和治理干预后妇幼保健服务表演的比较：倾向得分匹配分析

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Leadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing the work climate, and creating responsive health systems. Hence, the Ethiopian Ministry of Health with the support of the USAID Transform: Primary Health Care project has been implementing LMG interventions to improve performances of primary healthcare entities. The purpose of this evaluation was to compare maternal and child health service performances and overall health system strengthening measurement results of primary health care entities by LMG intervention exposed groups. The study used a cross-sectional study design with a propensity matched score analysis, and was conducted from August 28, 2017, to September 30, 2018, in Amhara, Oromia, Tigray, and Southern Nations, Nationalities, and Peoples’ (SNNP) regions. Data collection took place through interviewer and self-administered questionnaires among 227 LMG intervention exposed and 227 non-exposed health workers. Propensity score matched analysis was used to balance comparison groups with respect to measured covariates. The mean overall maternal and child health key performance indicator score with standard deviation (± SD) for the LMG intervention exposed group was 63.86?±?13.16 and 57.02?±?13.71 for the non-exposed group. The overall health system strengthening score for the LMG intervention exposed group (mean rank?=?269.31) and non-exposed group (mean rank?=?158.69) had statistically significant differences (U?=?10.145, z?=???11.175, p?=?0.001). In comparison with its counterpart, the LMG exposed group had higher average performances in 3.54, 3.51, 2.64, 3.00, 1.07, and 3.34 percentage-points for contraceptive acceptance rate, antenatal care, skilled birth attendance, postnatal care, full immunization, and growth monitoring services, respectively. There were evidences on the positive effects of the LMG intervention on increased maternal and child health services performances at primary healthcare entities. Moreover, health facilities with LMG intervention exposed health workers had higher and statistically significant differences in management systems, work climates, and readiness to face new challenges. Therefore, this study generated evidence for integrating LMG interventions to improve the performance of primary healthcare entities and maternal and child service uptake of community members, which contributes to the reduction of maternal and child deaths.
机译：领导，管理和治理（LMG）干预措施在改善管理系统，增强工作环境和创造敏感卫生系统方面发挥着重要作用。因此，埃塞俄比亚卫生部通过支持USAID变革：初级卫生保健项目一直在实施LMG干预，以改善原发性医疗实体的表现。该评估的目的是通过LMG干预暴露群体比较妇幼保健服务表演和整体卫生系统加强初级医疗实体的测量结果。该研究采用了横断面研究设计，具有倾向匹配的分数分析，并于2017年8月28日，2018年8月30日，在阿哈拉，奥罗马菊，德格莱德和南部国家，民族和人民（SNNP）中地区。数据收集通过面试官和自我管理的调查问卷，暴露227 LMG干预和227名非公开的卫生工作者。倾向得分匹配分析用于平衡比较群体的测量的协变量。 LMG干预暴露组的标准偏差（±SD）的平均总体母婴健康关键性能指标评分为63.86？±13.16和57.02？±13.71，适用于未暴露的组。整体卫生系统加强LMG干预暴露群体的得分（平均等级？= 269.31）和非暴露群（平均等级？=？158.69）在统计上存在统计学意义（U？=？10.145，Z？= ??? 11.175，p？= 0.001）。与其对应物相比，LMG曝光组在3.54,3.51,2.64,3.00,1.07和3.34个百分点中具有更高的平均性能，以获得避孕验收率，产前护理，熟练的出生，产后护理，全免疫和生长分别监测服务。对LMG干预对初级医疗实体的增加妇幼保健服务表演的积极影响有所证明。此外，具有LMG干预的卫生设施暴露的卫生工作者在管理系统，工作气候和准备方面具有更高且统计学上的差异，以面对新的挑战。因此，本研究产生了将LMG干预措施整合以改善初级医疗实体和妇幼保护人员的绩效的证据，这有助于减少母婴死亡。

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