Essential health services delivery status during COVID-19 pandemic in Ethiopia: A national mixed-methods survey of primary healthcare units

BACKGROUND: Essential health services are a package of services critical to improve health outcomes. COVID-19 pandemic disrupts essential health services. However, the level of essential health service disruption due to COVID-19 in Ethiopia is not clear. This study aimed at measuring the status of delivery of essential health services in Ethiopia during COVID-19. METHODS: A national mixed-methods cross-sectional survey was conducted. It was undertaken in Amhara (10 districts), Oromia (eight districts), Sidama (six districts), Southern Nations, Nationalities, and People's Region (16 districts), and Dire Dawa City Administration. A total of 452 health facilities were surveyed. Data were collected using face-to-face interview. Descriptive analysis was undertaken. Qualitative data was analyzed thematically. RESULTS: The woredas (districts) and health facilities which adopted essential health services before the COVID-19 pandemic were 81.4% and 51.2%, respectively. Nearly all health centers provided antenatal care services. Blood pressure measuring apparatus and delivery set were available in all health centers. However, only 50% of health centers had radiant warmer. Malnutrition services were provided by 47% of rural health centers. Moreover, a functional incinerator was available in only 41% of health centers. The provision of cardiovascular disease management was at 27.2%. Furthermore, HIV/AIDS treatment was provided by 43.5% of health facilities. CONCLUSION: The adoption of lists of essential health services was optimal. The status of delivery of essential health services was high for maternal healthcare. Neonatal care at birth, malnutrition treatment, and cardiovascular disease management were low. The district health system should strive more to maintain essential health services.

Trend of health worker's strike at a Tertiary Health Institution in North Central Nigeria

Objectives: Workers' strike is a global phenomenon since antiquity. In Nigeria, health-care sector has been rocked by series of strikes spanning variable periods with immeasurable losses. Ethical consideration and inter-professional rivalry are the main concern attracting much debate in the health sector. The objectives of the study were to determine the trend of health worker's strike actions, the main agitators, and to make some recommendations. Material and Methods: This was a retrospective study of the labor ward records of the Jos University Teaching Hospital from January 1, 1985, to December 31, 2019, duration of 35 years. The data were collated and analyzed using simple percentages and the figures corrected to the nearest decimal point. Results: A total of 42 strike actions, about 2 strikes/year. The trend shows a multi-modal pattern, with the highest peak of 5 strikes in 2004 and 2013. There were cumulatively 58.5 months of strikes out of the 442 months of the period of study, giving a percentage of 13.2%. While doctors had more frequent strikes (52.3%), non-doctors under the umbrella of Joint Health Sector Union and nurse/midwives accounted for over half (58.1%) of the duration of the strikes. The resident doctors are the main agitators of doctors' strike accounting for about half (45.2%) of the total health workers' strikes, while NMA accounted for only 3 (9.4.%). Most strike actions occur at the end of the year, with spill into the first quarter of the following year. Conclusion: Health workers' strike remains a perennial problem. Inter-professional rivalry is a major challenge in the health sector with far reaching implication without immediate government intervention. Addressing challenges in the residency training program will go a long way in reducing doctors' unrest in the health sector