Assessing Performance of Botswana’s Public Hospital System: The Use of the World Health Organization Health System Performance Assessment Framework
Publish Year: 1393
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_HPM-3-4_004
تاریخ نمایه سازی: 16 مرداد 1403
Abstract:
Background Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF). We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods This article is based on data collected from document analysis, ۵۴ key informants comprising senior managers and staff of the MoH (N= ۴۰) and senior officers from stakeholder organizations (N= ۱۴), and surveys of ۴۲ hospital managers and ۳۸۹ health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved useful in this study.
Keywords:
Botswana , Public Hospitals , Service Delivery , World Health Organization Health System Performance Assessment Framework (WHO HSPSF)
Authors
Onalenna Seitio-Kgokgwe
Ministry of Health, Gaborone, Botswana
Robin Gauld
Department of Preventive and Social Medicine, School of Medicine, University of Otago, Dunedin, New Zealand
Philip Hill
Department of Preventive and Social Medicine, School of Medicine, University of Otago, Dunedin, New Zealand
Pauline Barnett
School of Health Sciences at Canterbury, Christchurch, New Zealand
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