Browsing by Author "Tassew, Berhan(MPH)"

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    Assessment of dropout rate and associated factors from community based health insurance among informal workers in gumbichu woreda,Oromia region,Ethiopia.
    (Addis Abeba University, 2020-12) Kebite, Negash; Prof.HaileMariam, Damen; Tassew, Berhan(MPH)
    Background: Ethiopia has introduced community-based health insurance (CBHI) scheme to enhance healthcare services utilization and protect the poor from catastrophic health expenditure in 2011. Previous studies indicate that CBHI support the efforts being made to create access to primary healthcare services, a number of schemes are mostly constrained by low membership uptake, high dropout rate and exclusion of the poor. Objective: - To assess of dropout rate and associated factors from Community-based health insurance (CBHI) among informal workers in Gumbichu Woreda, East Shoa Zone, Oromia Region. Methods: Community-based cross-sectional study design was employed. Using interviewer administered questioners to assess factors affecting dropout of CBHI in Gumbichu Woreda. The study participants were selected by using systematic random sampling technique. The sample size required for the study is 624. Results: The study found that educational statuses of respondents were found to be an associated factor for dropout of CBHI. Households who are illiterate were 2.174 times more likely to drop out from CBHI than those who were secondary education and above, AOR = 2.174, 95% CI (0.906, 4.422). Socio-economic status of households also affect dropout. Household with wealth status of low income were 3.44 times more likely to drop out from the CBHI than those high wealth statuses, AOR = 3.44; 95% CI (1.344, 8.805). Households with middle income group were 1.238 times more likely to drop out than those high-income groups, AOR = 1.238; 95% CI (0.693, 2.213). Perceiving service quality is also reason and positively correlated with members to dropout from their membership (r=0.297 at p=0.00). Limited scope of illness covered by the scheme and distance from health facility are also reasons and positively correlated with members to dropout from their membership (r =0.272 at p = 0.00) and (r = 0.117 at p = 0.0015). Conclusion: This study brings reasons and factors for dropout of CBHI membership. It is found that education, socio-economic status, limited scope of illness, distance from health facility and quality of healthcare services were correlated with dropout of CBHI.
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    Health care services utilization and its determinant factors among health professionals, Addis Ababa, Ethiopia, 2018 G.C: Health facility based mixed study.
    (Addis Ababa University, 2018-10) Cheru, Miraj; HaileMariam, Damen(professor); Tassew, Berhan(MPH)
    Background: The main function of health system is ensuring the availability and accessibility of health service. Service provision is an immediate output of the health system, but health service utilization in sub Saharan Africa is very low. Similar to that the health service utilization in Ethiopia also is low. Dimensions that are barrier for health service utilization are geographic accessibility; availability of health workers, drugs and equipment; affordability and acceptability. Objective: To explore pattern of health service utilization and its determinant factors among health professionals in Addis Ababa, Ethiopia, 2018 G.C. Methods: Institutional-based cross-sectional study supplemented with a qualitative study was conducted to explore patterns of health service utilization and its determinant factors among health professionals by using stratified sampling technique. The total sample size for the study was 634 using single population sampling technique methods with 10% non-response rate. Data was collected using structured questionnaire for quantitative data and in depth interview was conducted on 12 respondents for qualitative data. To increase the quality of data training was provided to the data collectors to familiarize with the questionnaire, at the time of data collection data was checked for completeness and consistency by principal investigator and data was transcribed in full text and response in all interview sessions was reviewed and combined. EPI- info version 7 and SPSS version 20 for quantitative and open code version 3.6.2.0 for qualitative data was employed for analysis. Logistic regression was used and odds ratio was calculated to ascertain association between dependent and independent variable at p values of less than 0.05. The result had presented in tables, graphs, words and charts. Result: The final multivariate logistic regression model has shown that satisfaction on skill and competency of health care provider, having unhealthy perceived health status and having known chronic illness were found to have a statistically significant association with utilization of health care service. While participants who were satisfied with skill and competency of health care provider were 2.265 more likely utilize health service than not satisfied (AOR=2.265, 95% CI: 1.112, 5.627). Also respondents who perceived that their health status was healthy were 0.035 times less likely utilized health service than unhealthy (AOR=0.035, 95% CI: 0.009, 0.132). the xi | P a g e final multinomial regression shows that respondent that perceived that high cost of health care service are 7.902 more likely preferred health center than private clinics(AOR=7.902, 95% CI:2.301,27.141) ) The qualitative part of this study shown that majority of the respondents first they had observed within their health facility. But, they preferred advanced health facility in order to get advanced health care service. And also shown that there is free health care service for health care providers within government health facility but there is specific of amount of money planned annually to get health care service for staffs that are worked within non-governmental for non-profit health facility. Conclusion: In conclusion the level of health services utilization rate was found to be low. There is no uniform payment trend to utilize health care service employees among private, governmental and NGOs. Efforts have to be made to increase utilization of modern health services through establishing uniform payment trend among health facilities for health work forces.
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    Impact of non-communicable disease multi morbidity on health care utilization and out-of-pocket health expenditure at Tikur Anbessa specialized hospital Addis Ababa, Ethiopia, 2020.
    (Addis Abeba University, 2020-12) Habtemichael, Mizan; Molla, Meseret(PHD); Tassew, Berhan(MPH)
    Background:Out-of- pocket (OOP) health payment is the least efficient and most inequitable means of financing health care. In Ethiopia from the total health expenditure, OOP payment by household accounts 31 % which is more than the recommended 20%. Even though there are studies conducted on burden of OOP due to deferent NCDs like, cardiovascular disease, Cancer, diabetes mellitus and mental illness, there is no figure regarding the financial burden of OOP expenditure due to having more than one NCD (Multimorbidity). Objective: The study assessed the impact of NCD multimorbidity on health care utilization and OOP expenditure at Tikur Anbesa Specialized hospital, Addis Ababa in 2020. Method: Facility-based cross-sectional study was conducted at Tikur Anbesa Specialized Hospital from May 2020 to July 2020. Data was collected using pre-tested, structured intervieweradministered questionnaire. Data were entered using epi data version 3.1 and analyzed using STATAV 14. Binary logistic regressions, multivariable logistic regressions and negative binomial regression was used to examine the association between variables. Result: A total of 392 respondents were participated in this study and prevalence of NCD multimorbidity was 67 % (95%CI 62.2-71.5). The frequency of OPD visits was associated with the number of NCD (IRR= 1.2, 95%CI; 1.15-1.25, P-value < 0.001) and an increased number of NCDs was also associated with a higher likelihood of having hospitalization (AOR= 1.5, 95%CI; 1.19- 2.00, P-value < 0.001). We found 30.7% and 12.9% of households incurred catastrophic health expenditure (CHE) at 25% and 40% threshold of total household expenditure respectively. At a threshold level of 25% and 40% of household non-food expenditure, the level of catastrophic payments was 61.2% and 38.7% respectively. Conclusion and Recommendation: Multimorbid patients came to health facilities more frequently and they were exposed to increase financial problems. CHE mostly affected those households with older member, unemployed member, family member who came from outside of Addis Ababa to get health care services. Respondents who were in the poorest wealth quintile, those who have increased number of NCD conditions, those households with a hospitalized member, household who was not a member of an insurance system, those who use both public and private health facilities, and patients who visit a health facility frequently were affected by CHE.NCD multimorbid patients should be prioritized in the implementation of financial risk protection mechanisms.
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    Magnitude of Turnover Intention and Associated Factors Among Health Care Professionals in Public Primary Hospitals in North Shewa, Amhara Region, Ethiopia, 2020.
    (Addis Abeba University, 2020-11) Teklemariam, Sirak; Tassew, Berhan(MPH)
    Background:One of the most critical issues in public rural town primary hospitalis the high turnover intention of skilled manpower. Good workforce retention is vital to ensuring wellfunctioning health services capable of delivering improved health outcomes.Many factors such as salary,work environment and supervision influence the turnover intention. Objective: To assess the magnitude of turnover intention andassociated factors among health care workers in public primary hospitals in North Shewa,Amhara region. Method:A health facility-based cross-sectional study was conducted in public primary hospitals in NorthShewa,Amhara region from March 15 to June 15,2020, on 316 health professionals working in public primary hospitals usinga simple random sampling technique. The data were collected using pre-tested self-administered structured questionnaires. The data was entered into Epidata version 3.1 and was analyzed using SPSS version 23 software.Descriptive statistics were conducted to summarize the sample characteristics and to calculate the mean score as a cutoff point so that those below the mean score(mean=2.9) were considered as having a turnover intention. Result: Out of 316 health professionals who responded to the questionnaires,175(55.4%) of them reported to have intention to leave their current work place. The result showed that the socio-demographic factors were not significant, where as insufficientsalary[AOR=3.03(95%CI:1.24,4.41)],insufficientincentives[AOR=2.19(95% CI:1.10,4.04)],insufficient supply of equipment and supplies[AOR=1.93(95%CI:1.04,3.49)],shortage oftransportationaccess[AOR=1.89(95%CI:1.23,2.81)],workload[AOR=1.76(95%CI:1.02,2.41)],ins ufficient development and training[AOR=1.74(95%CI:1.00,2.45)],unsatisfied with the management bodies[AOR=1.700(95%CI:1.07,2.97)]and unavailability of clean water[AOR=1.67(95%CI:1.08,2.67)]and p<.001 for all factors were significantly associated with turnover intention of the health care professionals. Conclusions and recommendation :The magnitude of intention to leave among health care professionals working in public primary hospitals of North Shewa Zone Amhara Region was high. So it would be necessary to recommend that the hospital managers, the Zone health department and the region health bureau could be collaborated in order to reverse this intention and retain the health professionals based on these determinants found in this study.