The capacity of the health system to respond timely and adequately to the health needs of the people is critical to averting deaths, especially in vulnerable populations such as pregnant women and children. The robustness and responsiveness of a country’s health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of five (5) health system characteristics (i. type of health provider, ii. level of facility, iii. availability of essential medicines, iv. availability of basic equipment, and v. type of facility) on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black’s framework for evaluating the scale-up to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment (SARA) dataset, which comprised 100% (1,284) of the country’s health facilities. Data analysis included bivariate and multivariate logistic regressions. In the bivariate analysis, all the independent variables showed statistically significant association with access to MCH services and achieved a p-value < .001. In the multivariate analysis, however, only 3 predictors explained 38% of the variance (R² = .380, F (5, 1263) = 154.667, p<.001). The type of health provider significantly predicted access to MCH services (β =.549, p <.001) as did the availability of essential medicines (β= .255, p<.001) and the availability of basic equipment (β= .258, p <.001). According to the study findings, the availability of the right mix of health providers, essential medicines, and basic equipment significantly influenced access to MCH services, regardless of the level and type of health facility. The study has highlighted the relative influence of health system access to MCH services. The findings would inform efforts towards broadening strategies to address weak health system blocks to optimise access to quality MCH services, which ultimately can contribute towards the reduction of maternal and child mortality rates in Sierra Leone and similar contexts.
Author(s) Details
Alhassan Fouard Kanu
Institute for Health Professionals Development (IHPD), Sierra Leone and
Paris Graduate School, France.
Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v8/6993
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