Under-Five Child Health Service Quality and its Determinants in Goncha Siso Enessie District, Northwest Ethiopia, 2016

Volume 1 - Issue 5

Ayalew Shiferaw¹*, Molla Gedefaw² and Muluken Teshome³

Received: December 17, 2018;   Published: January 02, 2019

DOI: 10.32474/SCSOAJ.2019.01.000122

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Abstract

Background: Quality of health service is measured based on structure, process and outcome elements and has multidimensional concept that has been defined in various ways. It is an important aspect of health service delivery system and must be given priority in most countries.

Methods: A facility based cross sectional quantitative and qualitative study design was employed from January- May 2016 on 396 guardians of under five children. The data were collected using structured exit interviews, facility assessment checklists and record reviews. Data was cleaned and entered Microsoft office Access, EPI info and analyzed by Statistical Package for the Social Science. Binary and multivariate logistic regression was used to identify factors of guardians’ satisfaction and odds ratios, 95% CI and p-value was computed to measure the presence and strength of associations.

Results: The study showed that health centers and health posts on average fulfilled 32.4% of the health human power need and 44.1% of major equipment requirement against the national standards. The average adherence of health professional with guidelines of pneumonia and diarrhea managements was 76% and 65.6% respectively. Malnutrition was inappropriately managed and alarming in all components which needs program interventions. The composite average satisfaction level of guardians was 54.3%. Adequacy of information given about child health service (OR=0.49, 95% CI, =0.27, 0.91), expectation about the health services (OR=0.46, 95% CI, = 0.23, 0.91), privacy given during treatments (OR=0.21, 95% CI, = 0.08, 0.54) and preference of health institutions were the predictor variables (OR=0.18, 95% CI, = 0.09, 0.35) for under five child health service satisfactions of guardians.

Conclusion: The overall quality of health service was low compared to studies done at different areas on quality of health care. The health institutions were facing shortages of human power, material resources and low adherence with standard treatment guidelines especially on diarrhea and malnutrition managements. The responsible bodies of health sectors at different levels should take actions to improve institutional capacity and performance of care providers in order to improve quality of health services. There should also be continuous monitoring systems to health facilities focused on health care services to strengthen institutional capacity and performance of care providers.

Abbreviations: IMCI: Integrated Management of Childhood Illness; GMP: Growth Monitoring and Promotion; OTP: Out Patient Therapeutic Program; GMP: Growth Monitoring and Promotion; EPI: Expanded Programmed on Immunization

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