Measuring Ethiopia’s health system performance: More efforts are needed to achieve SDG 2030
DOI:
https://doi.org/10.20372/ejphn.v7i1.236Keywords:
composite coverage index, universal health coverage index, health system strengthen index Ethiopia, subnationalAbstract
Background: Health systems are essential platforms for accessible, quality health services, and population health improvements. Monitoring the coverage of interventions in maternal and child health continues to be central to assessing progress towards sustainable development goals. This study aimed to estimate the health system performance through composite coverage index, universal coverage and health system strengthen index.
Methods: To assess the health system performance, three indexes such as composite coverage index (CCI), universal health coverage index, and health system strengthen index were estimated. The composite coverage index was constructed from 11 tracer indicators of the continuum of care. The UHC service coverage index mainly focused on treatment and prevention was constructed from the geometric means from 14 tracer indicators. The health system strengthen index computed from two broad categories: health input and output scores. The data sources for all the analysis were from five Demographics and Health Surveys, health facility surveys, routine and administration reports. We estimated the national and subnational performance of the health system.
Results: The CCI showed over a twofold increase in 2019 (17.6 in 2000 to 55.0 in 2019) compared to 2000. The national UHC-service coverage index by 2020 was 34.0%. The coverage of RMNCH, infectious diseases, NCD and service capacity & access were 45.0%, 69.0%, 71.0% and 6.0%, respectively. The Health system strengthen index was 36.0% in 2020. There were variations on the composite coverage, universal health coverage and health system strengthen indexes by regions, wealth quintile place of residence, education level and regions.
Conclusion: In Ethiopia, there were improvements in health interventions coverage. Inevitable disparities in health service coverage existed by wealth quintile, mothers education level, residence, and regions. It is recommended that the policymakers at the national and subnational levels should take initiatives to narrow the disparities among subpopulations. The health system needs more intensified effort particularly to strengthen the service capacity and access, the health infrastructure and input to achieve the SDG -2030 goals
Metrics
Downloads
References
Barasa E, Nguhiu P & McIntyre D (2018). Measuring progress towards Sustainable Development Goal 3.8 on universal health coverage in Kenya. BMJ Global Health, 3(3), 1–14. https://doi.org/10.1136/bmjgh-2018-000904
Barros AJ & Victora CG (2013). Measuring Coverage in MNCH: Determining and Interpreting Inequalities in Coverage of Maternal, Newborn, and Child Health Interventions. PLoS Medicine, 10(5). https://doi.org/10.1371/journal.pmed.1001390
Boerma T, AbouZahr C, Evans D & Evans T (2014). Monitoring intervention coverage in the context of universal health coverage. PLoS Medicine, 11(9): e1001728. https://doi.org/10.1371/journal.pmed.1001728
Boerma T, Bryce JW, Kinfu Y, Axelson H & Victora CG (2008). Mind the gap: equity and trends in coverage of maternal, newborn, and child health services in 54 Countdown countries. The Lancet, 371, 1259–1267.
Boerma T, Eozenou P, Evans D, Evans T, Kieny MP & Wagstaff A (2014). Monitoring Progress towards Universal Health Coverage at Country and Global Levels. PLoS Medicine, 11(9). https://doi.org/10.1371/journal.pmed.1001731
Bryce J, Arnold F, Blanc A, Hancioglu A, Newby H, Requejo J, et al. (2013). Measuring coverage in MNCH: new findings, new strategies, and recommendations for action. PLoS Medicine, 10(5): e1001423. https://doi.org/10.1371/journal.pmed.1001423
CSA (2013). Central Statistical Agency Population Projections for Ethiopia 2007-2037.
Eregata GT, Hailu A, Memirie ST & Norheim OF (2019). Measuring progress towards universal health coverage: National and subnational analysis in Ethiopia. BMJ Global Health, 4(6): 1–9. https://doi.org/10.1136/bmjgh-2019-001843
Hogan DR, Stevens GA, Hosseinpoor AR & Boerma T (2018). Monitoring universal health coverage within the Sustainable Development Goals: development and baseline data for an index of essential health services. The Lancet Global Health, 6(2): e152–e168. https://doi.org/10.1016/S2214-109X(17)30472-2
Jacobs B, Ir P, Bigdeli M, Annear PL & Van Damme W (2012). Addressing access barriers to health services: an analytical framework for selecting appropriate interventions in low-income Asian countries. Health Policy and Planning, 27(4): 288–300. https://doi.org/10.1093/heapol/czr038
Kumalija CJ, Perera S, Masanja H, Rubona J, Ipuge Y, Mboera L, et al. (2015). Regional differences in intervention coverage and health system strength in Tanzania. PLoS ONE, 10(11): 1–14. https://doi.org/10.1371/journal.pone.0142066
Mebratie AD, Van De Poel E, Yilma Z, Abebaw D, Alemu G & Bedi AS (2014). Healthcare-seeking behaviour in rural Ethiopia: Evidence from clinical vignettes. BMJ Open, 4(2). https://doi.org/10.1136/ bmjopen-2013-004020.
MoH (2019). Ethiopia Health Accounts 2016/17. https://linkinghub.elsevier.com/retrieve/pii/S0140673600856020 MoH (2021). Health Sector Transformation Plan II 2020/2021-2024/2025. 25(February): 1–128.
Ruducha J, Mann C, Singh NS, Gemebo TD, Tessema NS, Baschieri A, et al. (2017). How Ethiopia achieved Millennium Development Goal 4 through multisectoral interventions: a Countdown to 2015 case study. The Lancet Global Health, 5(11): e1142–e1151. https://doi.org/10.1016/S2214-109X(17)30331-5
Rutstein SO & Rojas G (2006). Guide to DHS Statistics: Demographic and Health Surveys Methodology. DHS Publication, 1–168. https://www.dhsprogram.com/pubs/pdf/DHSG1/Guide_to_DHS_Statistics_29Oct2012_DHSG1.pdf
Sherr K, Fernandes Q, Kanté AM, Bawah A, Condo J, Mutale W, et al. (2017). Measuring health systems strength and its impact: Experiences from the African Health Initiative. BMC Health Services Research, 17(Suppl 3). https://doi.org/10.1186/s12913-017-2658-5
Stenberg K, Hanssen O, Edejer TTT, Bertram M, Brindley C, MeshrekyA, et al. (2017). Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries. The Lancet Global Health, 5(9): e875–e887. https://doi.org/10.1016/S2214-109X(17)30263-2
Wehrmeister FC, Barros AJD, Hosseinpoor AR, BoermaT & Victora CG (2020). Measuring universal health coverage in reproductive, maternal, newborn and child health: An update of the composite coverage index. PLoS ONE, 15(4), 1–10. https://doi.org/10.1371/journal.pone.0232350
Wehrmeister FC, Restrepo-Mendez MC, Franca GVA, Victora CG & Barros AJD (2016). Summary indices for monitoring universal coverage in maternal and child health care. Bulletin of the World Health Organization, 94(12): 903–912. https://doi.org/10.2471/BLT.16.173138
WHO & World Bank (2021). Global monitoring report on Universal Health Coverage.
WHO & Worldbank (2017). Tracking universal health coverage: 2017 global monitoring report. World Health Organization and International Bank for Reconstruction and Development / The World Bank; 2017. Licence: CC BY-NC-SA 3.0 IGO. https://doi.org/10.1596/978-92-4-151355-5
Downloads
Published
License
Copyright (c) 2024 Ethiopian Journal of Public Health and Nutrition (EJPHN)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This work is licensed under GNU General public license.