Customize Consent Preferences

We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.

The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ... 

Always Active

Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.

No cookies to display.

Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.

No cookies to display.

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.

No cookies to display.

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

No cookies to display.

Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.

No cookies to display.

Systematic review of the quality of care provided to sick children in Ethiopian health facilities
SSyysstteemmaattiicc rreevviieeww ooff tthhee qquuaalliittyy ooff ccaarree pprroovviiddeedd ttoo ssiicckk cchhiillddrreenn iinn EEtthhiiooppiiaann hheeaalltthh ffaacciilliittiieess

Systematic review of the quality of care provided to sick children in Ethiopian health facilities

J Glob Health. 2024 Nov 1;14:04243. doi: 10.7189/jogh.14.04243.

ABSTRACT

BACKGROUND: Despite the increasing number of primary studies on the quality of health care for sick children in Ethiopia, the findings have not been systematically synthesised to inform quality improvement in policies or strategies. This systematic review provides a narrative synthesis of published evidence on the quality of care provided to sick children in Ethiopia’s health facilities and on related barriers and enablers.

METHODS: We searched studies that measured the structure, process, and outcome measures of quality of care as proposed by Donabedian’s framework. We searched in PubMed/Medline, EMBASE, and Web of Science using the Population, Concept, and Context (PCC) framework. Grey literature was searched in Google Scholar and institutional websites. We appraised the studies’ quality using the Mixed Method Quality Appraisal Tool version 2018. Data were analysed using content thematic analysis and presented using a narrative approach.

RESULTS: We included 36 of 701 studies. Thirty (83.3%) were nonexperimental including 21 (70%) cross-sectional studies and five (16.7%) qualitative studies. Of the 31 facility-based studies, 29 (93.5%) were conducted in public facilities. The structural, technical, and interpersonal processes of care were low quality. While some studies reported the effectiveness of interventions in reducing child mortality, the uptake of services and providers’ and caretakers’ experiences were suboptimal. The major structural barriers to providing quality care included inadequacy of essential drugs, supplies and equipment, training, clinical guidelines, and ambulance services. Caretakers’ non-compliance to referral advice was a common demand-side barrier. The enabling factors were implementing various health system strengthening interventions including quality improvement strategies such as user-centred service delivery and optimising engagement of community-level structures such as health promotors and religious leaders to create demand.

CONCLUSIONS: The quality of care provided to sick children in health facilities is generally low in Ethiopia. Shortages of essential drugs, supplies and equipment, physical space, water, and electricity; and human resource-related challenges such as shortage, training, supervision, and retention were common structural barriers. Various health systems strengthening and quality improvement interventions, ranging from enhanced demand creation to realising a reliable and consumer-centred service delivery were key enablers. More research is needed on the quality of care provided in private facilities.

REGISTRATION: PROSPERO: CRD42021285064.

PMID:39479869 | DOI:10.7189/jogh.14.04243