Abstract:

The aim of the study was to assess the impact of health systems strengthening on the consumption of public healthcare services in Northern Namibia. The study assessed how the following components of health systems strengthening influence the consumption of public health care services; (1) timeliness and readiness of services rendered, (2) health workforce competence, (3) health information systems, (4) availability of essential medicines, (5) healthcare financing and lastly (6) leadership and governance. We used a quantitative descriptive cross-sectional study design. 672 respondents were identified using the purposive sampling technique and a well-structured Likert-scaled questionnaire was used for the interviews. Collected information was entered into data sets and analysis was done using Excel and Statistical Package for Social Sciences (SPSS) version 23.0 software. The results were that over 95% of the respondents strongly agreed with each of the factors assessed. Health systems strengthening remains an important factor in the delivery of health services. This was taken note of when 48% of the participants agreed that a good competent health workforce determines their choice of healthcare facility when they are not feeling well. This was further augmented when 49% of the participants agreed that healthcare financing influences people’s choice to go and seek healthcare services from government facilities. It was concluded that health systems strengthening is the cornerstone for improved consumption of public health care services in Northern Namibia. We recommend that governments should develop strong health systems at all levels of health service delivery.

References:

[1] Adeoti, A.I and Awoniyi B, (2012). “Determinants of child and maternal health status and demand for health care services in Nigeria”. Editorial express.com/cgibin/conference/download.cgi?db_name=CSAE2012&paper_id=679.

[2] Everybody’s business — Strengthening health systems to improve health outcomes. WHO’s framework for action. Geneva, World Health Organization, 2007 (http://www.who.int/healthsystems/strategy/everybodys_business.pdf, accessed 26 April 2010).

[3] Monitoring and evaluation of health systems strengthening. An operational framework. Paper prepared by WHO, World Bank, Global Alliance on Vaccines Initiative (GAVI) and Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) (http://www.who.int/healthinfo/HSS_MandE_framework_Nov_2009.pdf, accessed 15 June 2010).

[4] World health report 2000. Health systems performance assessment. Geneva, World Health Organization, 2000(http://www.who.int/whr/2000/en/ndex.html, accessed 26 April 2010).

[5] Roberts MJ, Hsiao W, Berman P, Reich MR. Getting health reform right: a guide to improving performance and equity. New York, Oxford University Press, 2008.

[6] Ghuman, B.S., Mehta Akshat 2005 Health Care for the Poor in India with Special Reference to Punjab State, Network of Asia-Pacific Schools and Institutes of Public Administration and Governance (NAPSIPAG) Annual Conference 2005, Beijing, PRC, 5-7.

[7] International Monetary Fund (2005): International Monetary Fund Annual Report 2005: Making the Global Economy Work for All, retrieved from: https://www.imf.org/en/Publications/AREB/Issues/2016/12/31/International-Monetary-Fund-Annual-Report-2005-Making-the-Global-Economy-Work-for-All-18002.

[8] Republic of Kenya (2005). Kibera Social and Economic Mapping. Household survey Report.

[9] Mwabu G.M., Ainsworth, M., Nyamete, A., (1993). “Quality of Medical Care and Choice of Medical Treatment in Kenya. An Empirical Analysis”. Journal of Human Resources 28(4), 283-291.

[10] Kothari, C.R. (2009) Research Methodology: Methods and Techniques. New Age International, 401 p.

[11] Newing, H. (2011). Conducting Research in Conservation: Social science methods and practice. Routledge, New York, United States of America.

[12] Castillo, J. J. (2009). Snowball sampling. Retrieved from Experiment Resources: http://www.experimentresources.com/snowball-sampling.html.

[13] Naing, Lin & Winn, Than & Nordin, Rusli. (2006). Practical Issues in Calculating the Sample Size for Prevalence Studies. Archives of Orofacial Sciences. 1.

[14] Lavrakas, Paul. (2008). Encyclopedia of Survey Research Methods. 10.4135/9781412963947.

[15] Miller, G. J. and Yang, K. (2008). Handbook of Research Methods in Public Administration. New York: Auerbach Publications, Taylor & Francis Group Modell, S. (2004) Performance.

[16] Scott, A.J. and Wild, C.J. (1986) Fitting Logistic Models under Case-Control or Choice Based Sampling. Journal of the Royal Statistical Society. Series B (Methodological), 48, 170-182. https://doi.org/10.1111/j.2517-6161.1986.tb01400.x.

[17] Advising on Research Methods: A Consultant’s Companion, by Herman J. Ad`er, Gideon J. Mellenberg hand David J. Hand, Huizen, Johannesvan Kessel Publishing, 2008, 574pp, ISBN978-9079418-01-5.

[18] Trochim, William M. K. (October 20, 2006). “Likert Scaling”. Research Methods Knowledge Base, 2nd Edition; Galili, Tal (2010-04-07).

[19] Montgomery, D.C., Peck, E.A. and Vining, G.G. (2001) Introduction to Linear Regression Analysis. 3rd Edition, Wiley, New York.

[20] Burns, N., and Grove, K. (2003). Understanding nursing research (3rd ed.). Philadelphia: W.B. Saunders Company.

[21] Yang, K. (2008). Handbook of Research Methods in Public Administration. Taylor & Francis Group, New York.

[22] Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approach (2nd ed.). Thousand Oaks, CA: Sage.

[23] Book Review Research Methods in Education (6th Edition) by Louis Cohen, Lawrence Manion and Keith Morrison 656 pp, Routledge, London, UK, 2007; ISBN 0-415-36878-2.

[24] Health Metrics Network framework and standards for country health information systems. Second edition. Geneva, World Health Organization, 2008 (http://www.who.int/healthmetrics/documents/hmn_framework200803.pdf, accessed 26 April 2010).

[25] Alderman, H. & Gertler, P. (1989). Substitutability of public and private health care for the treatment of children in Pakistan. Living Standards Measurement Study Working Paper 57, Washington: The World Bank.

[26] John, G., and Johnson, P. (2002). Research Methods for Managers, 3rd ed., Sage Publications, London, United Kingdom.

[27] Sapsford, R. and Jupp, V. (2006). Data collection and analysis. SAGE. pp. 28–. ISBN 978-0-7619-4363-1. Retrieved 2 November 2011.

[28] Schwartz J.B., Akin, J.S., Popkin, P.M. (1980). “Price and Income Elasticities of Demand for Modern Health Care: the case of Infant Delivery in the Philippines”. Word Economic Review.2(1):49-76.

[29] Rous, J. J. & Hotchkiss, D. R. (2003). Estimation of the determinants of household health care expenditures in Nepal with controls for endogenous illness and provider choice. Health Economics, 12: 431–451.

[30] Marczyk, G., DeMatteo, D., & Festinger, D. (2005). Essentials of research design and methodology. Hoboken, NJ: John Wiley & Sons.

[31] Namibia (2020): The Institute for Health Metrics and Evaluation. Retrieved from: https://www.healthdata.org/namibia: institute for health metrics and evaluation-Namibia, 2020.