Conectar
Our objective was to assess the feasibility of using the routine health information system data source, District Health Information System (DHIS2) to measure the effective coverage of selected health service indicators in Ethiopia and to explore stakeholder perceptions of those measures.
We conducted a mixed-methods study. We mapped the availability of data elements in DHIS2 between July 2022 and June 2023 for five indicators (four or more antenatal care visits (ANC4+), skilled birth attendance, postnatal care, sick child care and child nutrition care). We defined effective coverage cascade steps for each indicator, assessed data quality and analysed data using STATA V.17. Finally, qualitative interviews were conducted with 15 key stakeholders, and the data were analysed thematically for reflections on the DHIS2 output.
The data were captured from all public health facilities of 11 regions and 2 administrative cities in Ethiopia.
There was better availability of data elements for maternal healthcare than for child healthcare. It was possible to estimate the intervention-adjusted coverage of ANC4+ (16% nationally) and the process-quality-adjusted coverage of skilled birth attendance (19% nationally). Postnatal care, sick child care and child nutrition indicators lacked data across multiple cascade steps. The quality of data for effective coverage measurement differed by region. The key informants expressed concerns about the adequacy and appropriateness of DHIS2 data for this analysis. While all acknowledged its potential for decision-making, respondents emphasised the need for standardised methods and data sources to enhance comparability and acceptability of the findings.
The findings underscore the need for system-level improvement of data availability and quality, and adoption of a standardised approach to calculating effective coverage using DHIS2. There was a concern that the findings may not be accepted by policymakers; however, the local level granularity made possible through DHIS2 was appreciated.
by Abebe Fenta, Tebelay Dilnessa, Destaw Kebede, Mekuriaw Belayneh, Zigale Hibstu Teffera, Bewket Mesganaw, Adane Adugna, Wubetu Yihunie Belay, Habtamu Belew, Desalegn Abebaw, Bantayehu Addis Tegegne, Zelalem Dejazmach, Fassikaw Kebede, Gashaw Azanaw Amare
BackgroundCo-infection with the human immunodeficiency virus (HIV) and tuberculosis (TB) is a primary cause of death and morbidity. The rate of morbidity and death from TB-HIV is still Ethiopia’s top health issue.
ObjectiveThis study aimed to assess the incidence and predictors of mortality among TB-HIV co-infected individuals on anti-TB and anti-retroviral dual Therapy at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.
MethodsA retrospective cohort study was conducted at the Debre Markos Comprehensive Specialized Hospital among 436 TB-HIV co-infected individuals. A computer-generated random sampling technique was used to select patient charts registered from September 1st, 2011, and August 31st, 2020. Epi-Data version 3.1 was used for data entry, and STATA version 13 was used for the analysis. The Kaplan-Meier survival curve was applied to estimate the cumulative survival time of the TB-HIV patients. Log-rank tests were utilized to compare the survival time across various categories of explanatory variables. Bi-variable and multivariable Cox proportional hazard models were fitted to find predictors of TB-HIV mortality.
ResultsThe mortality rate of TB-HIV co-infected individuals was 15.6%, with a median survival time of 42 months. Being male (Adjusted hazard Ratio (AHR)1.914;95%CI: 1.022–3.584), having CD4 count Conclusion and recommendation
The mortality rate among TB-HIV co-infected patients at Debre Markos Comprehensive Specialized Hospital was high. Being male gender, having a CD4 count below 50 cells/mm³, being ambulatory and bedridden, having low baseline weight, and having low hemoglobin were the important predictors of mortality. To reduce mortality, it is crucial to focus on the early identification and management of high-risk patients, particularly those with low CD4 counts, poor functional status, and low hemoglobin. Strengthening integrated TB and HIV care services is recommended to improve patient survival outcomes.
FreshRSS 