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Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique
INTRODUCTION: The effectiveness of facility-level management is an important determinant of primary health care (PHC) reach and quality; however, the nature of the relationship between facility-level management and health system effectiveness lacks sufficient empirical grounding. We describe the ass...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Global Health: Science and Practice
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476484/ https://www.ncbi.nlm.nih.gov/pubmed/36109052 http://dx.doi.org/10.9745/GHSP-D-21-00706 |
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author | Pope, Stephen Augusto, Orvalho Fernandes, Quinhas Gimbel, Sarah Ramiro, Isaías Uetela, Dorlim Tembe, Stélio Kimball, Meredith Manaca, Mélia Anderson, C. Leigh Chicumbe, Sérgio Sherr, Kenneth |
author_facet | Pope, Stephen Augusto, Orvalho Fernandes, Quinhas Gimbel, Sarah Ramiro, Isaías Uetela, Dorlim Tembe, Stélio Kimball, Meredith Manaca, Mélia Anderson, C. Leigh Chicumbe, Sérgio Sherr, Kenneth |
author_sort | Pope, Stephen |
collection | PubMed |
description | INTRODUCTION: The effectiveness of facility-level management is an important determinant of primary health care (PHC) reach and quality; however, the nature of the relationship between facility-level management and health system effectiveness lacks sufficient empirical grounding. We describe the association between management effectiveness and facility readiness to provide family planning services in central Mozambique. METHODS: We linked data from the Ministry of Health’s 2018 Service Availability and Readiness Assessment and a second 2018 health facility survey that included the World Bank’s Service Delivery Indicators management module. Our analysis focused on 68 public sector PHC facilities in Manica, Sofala, Tete, and Zambézia provinces in which the 2 surveys overlapped. We used logistic quantile regression to model associations between management strength and family planning service readiness. RESULTS: Of the 68 facility managers, 47 (69.1%) were first-time managers and (18) 26.5% had received formal management training. Managers indicated that 63.6% of their time was spent on management responsibilities, 63.2% of their employees had received a performance review in the year preceding the survey, and 12.5% of employee incentives were linked to performance evaluations. Adjusting for facility type and distance to the provincial capital, facility management effectiveness, and urban location were significantly associated with higher levels of readiness for family planning service delivery. CONCLUSIONS: We found that a higher degree of management effectiveness is independently associated with an increased likelihood of improved family planning service readiness. Furthermore, we describe barriers to effective PHC service management, including managers lacking formal training and spending a significant amount of time on nonmanagerial duties. Strengthening management capacity and reinforcing management practices at the PHC level are needed to improve health system readiness and outputs, which is essential for achieving global Sustainable Development Goals and universal health coverage targets. |
format | Online Article Text |
id | pubmed-9476484 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Global Health: Science and Practice |
record_format | MEDLINE/PubMed |
spelling | pubmed-94764842022-09-26 Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique Pope, Stephen Augusto, Orvalho Fernandes, Quinhas Gimbel, Sarah Ramiro, Isaías Uetela, Dorlim Tembe, Stélio Kimball, Meredith Manaca, Mélia Anderson, C. Leigh Chicumbe, Sérgio Sherr, Kenneth Glob Health Sci Pract Original Article INTRODUCTION: The effectiveness of facility-level management is an important determinant of primary health care (PHC) reach and quality; however, the nature of the relationship between facility-level management and health system effectiveness lacks sufficient empirical grounding. We describe the association between management effectiveness and facility readiness to provide family planning services in central Mozambique. METHODS: We linked data from the Ministry of Health’s 2018 Service Availability and Readiness Assessment and a second 2018 health facility survey that included the World Bank’s Service Delivery Indicators management module. Our analysis focused on 68 public sector PHC facilities in Manica, Sofala, Tete, and Zambézia provinces in which the 2 surveys overlapped. We used logistic quantile regression to model associations between management strength and family planning service readiness. RESULTS: Of the 68 facility managers, 47 (69.1%) were first-time managers and (18) 26.5% had received formal management training. Managers indicated that 63.6% of their time was spent on management responsibilities, 63.2% of their employees had received a performance review in the year preceding the survey, and 12.5% of employee incentives were linked to performance evaluations. Adjusting for facility type and distance to the provincial capital, facility management effectiveness, and urban location were significantly associated with higher levels of readiness for family planning service delivery. CONCLUSIONS: We found that a higher degree of management effectiveness is independently associated with an increased likelihood of improved family planning service readiness. Furthermore, we describe barriers to effective PHC service management, including managers lacking formal training and spending a significant amount of time on nonmanagerial duties. Strengthening management capacity and reinforcing management practices at the PHC level are needed to improve health system readiness and outputs, which is essential for achieving global Sustainable Development Goals and universal health coverage targets. Global Health: Science and Practice 2022-09-15 /pmc/articles/PMC9476484/ /pubmed/36109052 http://dx.doi.org/10.9745/GHSP-D-21-00706 Text en © Pope et al. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-21-00706 |
spellingShingle | Original Article Pope, Stephen Augusto, Orvalho Fernandes, Quinhas Gimbel, Sarah Ramiro, Isaías Uetela, Dorlim Tembe, Stélio Kimball, Meredith Manaca, Mélia Anderson, C. Leigh Chicumbe, Sérgio Sherr, Kenneth Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique |
title | Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique |
title_full | Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique |
title_fullStr | Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique |
title_full_unstemmed | Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique |
title_short | Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique |
title_sort | primary health care management effectiveness as a driver of family planning service readiness: a cross-sectional analysis in central mozambique |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476484/ https://www.ncbi.nlm.nih.gov/pubmed/36109052 http://dx.doi.org/10.9745/GHSP-D-21-00706 |
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