埃塞俄比亚卫生推广服务的利用情况：系统评价与荟萃分析。

Health extension service utilization in Ethiopia: systematic review and meta-analysis.

作者信息

Tiruneh Misganaw Guadie, Fenta Eneyew Talie, Endeshaw Destaw, Delie Amare Mebrat, Adal Ousman, Tareke Abiyu Abadi, Bogale Eyob Ketema, Anagaw Tadele Fentabel

机构信息

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.

Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.

出版信息

BMC Health Serv Res. 2024 Apr 26;24(1):537. doi: 10.1186/s12913-024-11038-4.

DOI:10.1186/s12913-024-11038-4

PMID:38671447

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11046976/

Abstract

INTRODUCTION

Ethiopia strives to achieve Universal Health Coverage (UHC) through Primary Health Care (PHC) by expanding access to services and improving the quality and equitable comprehensive health services at all levels. The Health Extension Program (HEP) is an innovative strategy to deliver primary healthcare services in Ethiopia and is designed to provide basic healthcare to approximately 5000 people through a health post (HP) at the grassroots level. Thus, this review aimed to assess the magnitude of health extension service utilization in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was used for this review and meta-analysis. The electronic databases (PubMed, Cochrane Library, and African Journals Online) and search engines (Google Scholar and Grey literature) were searched to retrieve articles by using keywords. The Joanna Briggs Institute (JBI) meta-analysis of statistics assessment and review instrument was used to assess the quality of the studies. Heterogeneity was assessed using the I statistic. The meta-analysis with a 95% confidence interval using STATA 17 software was computed to present the pooled utilization of health extension services. Publication bias was assessed by visually inspecting the funnel plot and statistical tests using Egger's and Begg's tests.

RESULT

22 studies were included in the systematic review with a total of 28,171 participants, and 8 studies were included in the meta-analysis. The overall pooled magnitude of health extension service utilization was 58.5% (95% CI: 40.53, 76.48%). In the sub-group analysis, the highest pooled proportion of health extension service utilization was 60.42% (28.07, 92.77%) in the mixed study design, and in studies published after 2018, 59.38% (36.42, 82.33%). All studies were found to be within the confidence interval of the pooled proportion of health extension service utilization in leave-out sensitivity analysis.

CONCLUSIONS

The utilization of health extension services was found to be low compared to the national recommendation. Therefore, policymakers and health planners should come up with a wide variety of health extension service utilization strategies to achieve universal health coverage through the primary health care.

摘要

引言

埃塞俄比亚致力于通过初级卫生保健（PHC）实现全民健康覆盖（UHC），方法是扩大服务可及性并提高各级卫生服务的质量和公平全面性。卫生推广计划（HEP）是埃塞俄比亚提供初级卫生保健服务的一项创新战略，旨在通过基层的卫生站（HP）为约5000人提供基本医疗保健。因此，本综述旨在评估埃塞俄比亚卫生推广服务的利用程度。

方法

本综述和荟萃分析采用系统评价与荟萃分析的首选报告项目（PRISMA）清单指南。通过使用关键词检索电子数据库（PubMed、Cochrane图书馆和非洲期刊在线）和搜索引擎（谷歌学术和灰色文献）来获取文章。使用乔安娜·布里格斯研究所（JBI）的统计评估与综述工具的荟萃分析来评估研究质量。使用I统计量评估异质性。使用STATA 17软件计算95%置信区间的荟萃分析，以呈现卫生推广服务的综合利用率。通过直观检查漏斗图和使用Egger检验和Begg检验的统计测试来评估发表偏倚。

结果

系统评价纳入了22项研究，共有28171名参与者，荟萃分析纳入了8项研究。卫生推广服务的总体综合利用程度为58.5%（95%置信区间：40.53，76.48%）。在亚组分析中，混合研究设计中卫生推广服务利用的最高综合比例为60.42%（28.07，92.77%），在2018年后发表的研究中为59.38%（36.42，82.33%）。在留一法敏感性分析中，所有研究均在卫生推广服务利用综合比例的置信区间内。