Univesrity of Gondar comprehensive specialized hospital, Gondar, Ethiopia.
Department of health systems and policy, Institute of public health, College of medicine and health sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2022 Sep 23;17(9):e0274090. doi: 10.1371/journal.pone.0274090. eCollection 2022.
Family planning program is low-cost and an effective way to lower maternalmortality by reducing the number of high-risk births. Despite the effectiveness of the program, availability of materials, equipment and trained healthcare providers were some of the challenges in sub-Saharan African countries including Ethiopia. Determining the implementation status and identifying gaps is the aim of this evaluation.
A facility-based cross-sectional evaluation design with mixed method approach was employed. Quantitative data was collected through the exit interview of 477 clients from March 25-April 25, 2020. The evaluation focused on three dimensions: availability, compliance, and acceptability with multiple data sources. The quantitative data were entered in to Epi-data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done to determine factors associated with client satisfaction. The qualitative data were transcribed, translated and analyzed by using thematic analysis. The evaluation finding was computed and compared with the preset criteria for the final judgment.
The majority of the health care providers (69.8%) got family planning training in the past two years. Three health facilities (37.5%) had 24hrs electricity with backup generators whereas only 25% of the health facilities had functional piped water inside the service room. Only two (25%) health facilities had a separate room for family planning service and 37.5% of health facilities had national FP guidelines. The overall availability of required resources for family planning service at Gondar city public facilities were 62.1%. Only twenty one (26.3%) of health providers dressed based on dressing code of ethics and none of them had ID during our observation. The overall compliance level of health care providers during providing family planning services were 75.5%. About 53.9% of the clients were satisfied with family planning service provided at Gondar city public health facilities.-and-were significantly associated variables with client satisfaction.
The overall implementation of family planning service in Gondar city public health facilities with the three evaluation dimensions were judged as fair based on pre-setting judgment matrix. It is better to improve the service through training of healthcare providers, distributed family planning guidelines to health facilities and shortening of waiting time for service.
计划生育项目是一种低成本且有效的方法,可以通过减少高危分娩的数量来降低孕产妇死亡率。尽管该项目具有有效性,但在包括埃塞俄比亚在内的撒哈拉以南非洲国家,材料、设备和经过培训的医疗保健提供者的可用性仍然是一些挑战。确定实施状况并确定差距是本次评估的目的。
采用基于设施的横断面评估设计和混合方法。通过 2020 年 3 月 25 日至 4 月 25 日对 477 名客户进行的出口访谈收集定量数据。评估重点关注三个维度:可用性、合规性和可接受性,使用多个数据源。定量数据输入到 Epi-data 版本 4.6 中,并导出到 SPSS 版本 25 进行分析。采用多变量逻辑回归确定与客户满意度相关的因素。定性数据经过转录、翻译和主题分析进行分析。评估结果进行计算,并与预设标准进行比较,以做出最终判断。
大多数医疗保健提供者(69.8%)在过去两年接受过计划生育培训。有三个卫生机构(37.5%)拥有 24 小时电力并配备备用发电机,而只有 25%的卫生机构在服务室内有功能正常的自来水。仅有两个(25%)卫生机构设有单独的计划生育服务室,37.5%的卫生机构有国家计划生育指南。贡德尔市公共设施提供计划生育服务所需资源的总体可用性为 62.1%。在我们观察期间,只有 21 名(26.3%)医疗保健提供者按照道德着装规范着装,没有一名医疗保健提供者有身份证。医疗保健提供者在提供计划生育服务时的总体合规水平为 75.5%。大约 53.9%的客户对贡德尔市公共卫生设施提供的计划生育服务表示满意,这是与客户满意度相关的显著变量。
根据预设的判断矩阵,贡德尔市公共卫生设施的计划生育服务整体实施情况在三个评估维度上被判定为良好。通过培训医疗保健提供者、向卫生机构分发计划生育指南以及缩短服务等待时间,可以更好地改进服务。