Comparing the levels of hospital’s social accountability: Based on ownership

Mahmoudi, Ghahraman; Jahani, Mohammad Ali; Rostami, Fatemeh; Mahmoudjanloo, Shahrbanoo; Nikbakht, Hossein-Ali

doi:10.1080/20479700.2017.1417074

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…This is contrary to what has been reported from low and middle-income countries. Five studies on social accountability from Nigeria [ 63 ] and Iran [ 64 – 67 ] have shown private-owned healthcare facilities are more socially accountable compared to public-owned ones. However, this is not by surprise.…”

Section: Discussionmentioning

confidence: 99%

Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment

et al. 2022

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Background Star Rating Assessment (SRA) was initiated in 2015 in Tanzania aiming at improving the quality of services provided in Primary Healthcare (PHC) facilities. Social accountability (SA) is among the 12 assessment areas of SRA tools. We aimed to assess the SA performance and its predictors among PHC facilities in Tanzania based on findings of a nationwide reassessment conducted in 2017/18. Methods We used the SRA database with results of 2017/2018 to perform a cross-sectional secondary data analysis on SA dataset. We used proportions to determine the performance of the following five SA indicators: functional committees/boards, display of information on available resources, addressing local concerns, health workers’ engagement with local community, and involvement of community in facility planning process. A facility needed four indicators to be qualified as socially accountable. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine facilities characteristics associated with SA, namely location (urban or rural), ownership (private or public) and level of service (hospital, health centre or dispensary). Results We included a total of 3,032 PHC facilities of which majority were dispensaries (86.4%), public-owned (76.3%), and located in rural areas (76.0%). On average, 30.4% of the facilities were socially accountable; 72.0% engaged with local communities; and 65.5% involved communities in facility planning process. Nevertheless, as few as 22.5% had functional Health Committees/Boards. A facility was likely to be socially-accountable if public-owned [AOR 5.92; CI: 4.48–7.82, p = 0.001], based in urban areas [AOR 1.25; 95% CI: 1.01–1.53, p = 0.038] or operates at a level higher than Dispensaries (Health centre or Hospital levels) Conclusion Most of the Tanzanian PHC facilities are not socially accountable and therefore much effort in improving the situation should be done. The efforts should target the lower-level facilities, private-owned and rural-based PHC facilities. Regional authorities must capacitate facility committees/boards and ensure guidelines on SA are followed.

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Section: Discussionmentioning

confidence: 99%

Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment

et al. 2022

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“…The promotion of a community-based perspective in university is among the facilitators of accountability in the students. Several studies in Iran also indicated that the medical sciences universities in recent years made critical contributions to community education (24)(25)(26). For example, integration at Shiraz University of Medical Sciences carried out on horizontal and vertical levels had satisfactory results (15).…”

Section: Discussionmentioning

confidence: 99%

Challenges and Motivational Facilitators of Social Accountability in Medical Students of Shiraz University of Medical Sciences: A Qualitative Study

et al. 2020

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Background: Accountability in the community is one of the main missions of the medical school. Objectives: The current study aimed at explaining the motivational facilitators and challenges in medical students of Shiraz University of Medical Sciences, Shiraz, Iran, for social accountability based on their experiences. Methods: The current study using semi-structured interviews was conducted on 28 individuals, 16 of whom were students and 12 professors and managers of the medical school. Purposeful sampling was used up to saturation. Data were analyzed using the content analysis method. First, conceptual codes were extracted and then grouped into several main themes. Selected concepts or main themes included facilitators, inhibitors, or challengers. Results: Selected concepts or main themes included facilitating factors and educational challenges for the social accountability of the students. The facilitators included informed choice, personality and moral commitment, content and process of motivation, promotion of community-based learning in the university, and the role of professors in motivation. The inhibitors or challenges included traditional routines, ineffective evaluations, manners of meeting the students’ needs, the lack of educational facilities, and the impact of the increased number of students on the quality of education. Conclusions: According to the current study findings, the conditions and facilities should be shared among medical education programs to provide a supportive environment for the students, and take a positive and effective step toward motivating them to improve their accountability.

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“…While the strategies could be seen as acting upon a situation occurring within the institution, the institution as a whole must be seen as having collective responsibility and scope for action. Overall, social accountability is an effective strategy for improving the quality and performance of health-care service providers and institutions and it has been shown to have better status in private hospitals compared to public and teaching ones [20]. In low-and middle-income countries, such as Jamaica, the majority of hospital care of the population is delivered through public hospitals.…”

Section: Strategies Guidelines and Lessons For Lmicsmentioning

confidence: 99%

Introductory Chapter: Mortality and Quality of Care Systems in LMICs

Mullings¹,

Binns²,

Thoms-Rodriguez³

et al. 2019

Strategies to Reduce Hospital Mortality in Lower and Middle Income Countries (LMICs) and Resource-Limited Settings

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Mortality data is a key indicator of the health of a population, with life expectancy being a commonly reported measure. Most recent estimates (2015) place global life expectancy at birth at 71.4 years but with significant regional differences. Improvements in life expectancy over the last few decades are reflected in the 55% of global deaths which occurred among older persons 65 years and over (moving from 41% in 1990). This development is a marker of socioeconomic development and progress in the reduction of premature deaths [1]. In 2017 approximately 56 million deaths were recorded and of that number non-communicable diseases (NCDs); communicable, maternal, neonatal and nutritional diseases; and injuries accounted for 72.3, 19.3, and 4.6% of deaths, respectively [2]. Cause-specific mortality for the top 10 leading causes of death was attributed to cardiovascular diseases (32.26%), cancers (16.32%), respiratory diseases (6.48%), diabetes (5.83%), dementia (4.36%), lower respiratory infections (4.35%), neonatal deaths (3.16%), diarrheal diseases (3.03%), road incidents (2.45%), and liver disease (2.3%) [2]. Globally, the predominant risk factors for mortality are preventable and include high blood pressure, smoking, high blood sugar, high body mass index (obesity), high cholesterol, outdoor air pollution, alcohol use, household air pollution, low fruit diets, and low vegetable diet. While both men and women have metabolic and behavioral risk factors for early death and disability, the leading behavioral risk factors for men were smoking and alcohol consumption, while for women metabolic risk factors were predominant (e.g., high systolic blood pressure, glucose, and body mass index) [2]. The association between nutrition and NCDs may have arguably originated in utero [3], and an increased awareness of epigenetics has thickened the discussion around NCDs and associated mortality. Discussions on health disparities and NCDs have also become increasingly relevant, especially given global economic disparities and social risks which directly impact on the poor, marginalized and other vulnerable populations. This is oftentimes compounded by deficiencies in health literacy and inadequate integration of evidence-based models in health care. While non-communicable diseases have largely accounted for global deaths, acute and chronic respiratory conditions remain the major threats to survival. In 2016, the top two leading causes of death in low-income countries were noncommunicable diseases-lower respiratory infections and diarrhoeal diseases [2].

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Comparing the levels of hospital’s social accountability: Based on ownership

Cited by 5 publications

References 24 publications

Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment

Social accountability in primary health care facilities in Tanzania: Results from Star Rating Assessment

Challenges and Motivational Facilitators of Social Accountability in Medical Students of Shiraz University of Medical Sciences: A Qualitative Study

Introductory Chapter: Mortality and Quality of Care Systems in LMICs

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